肺移植与致敏患者时代。
Lung Transplantation and the Era of the Sensitized Patient.
机构信息
Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, United States.
Department of Pharmacy, Duke University Hospital, Durham, NC, United States.
出版信息
Front Immunol. 2021 May 26;12:689420. doi: 10.3389/fimmu.2021.689420. eCollection 2021.
Abstract
Long term outcomes in lung transplant are limited by the development of chronic lung allograft dysfunction (CLAD). Within the past several decades, antibody-mediated rejection (AMR) has been recognized as a risk factor for CLAD. The presence of HLA antibodies in lung transplant candidates, "sensitized patients" may predispose patients to AMR, CLAD, and higher mortality after transplant. This review will discuss issues surrounding the sensitized patient, including mechanisms of sensitization, implications within lung transplant, and management strategies.
摘要
肺移植的长期预后受到慢性肺移植物功能障碍（CLAD）的发展限制。在过去几十年中，抗体介导的排斥反应（AMR）已被认为是 CLAD 的一个危险因素。肺移植受者中 HLA 抗体的存在，即“致敏患者”，可能使患者易患 AMR、CLAD 和移植后更高的死亡率。本文将讨论致敏患者的相关问题，包括致敏的机制、对肺移植的影响以及管理策略。
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