Comprehensive Transplant Institute, University of Alabama at Birmingham, Birmingham, AL, United States.
Front Immunol. 2021 Jul 30;12:696467. doi: 10.3389/fimmu.2021.696467. eCollection 2021.
Blood group and tissue incompatibilities remain significant barriers to achieving transplantation. Although no patient should be labeled "un-transplantable" due to blood group or tissue incompatibility, all candidates should be provided with individualized and realistic counseling regarding their anticipated wait times for deceased donor or kidney paired donation matching, with early referral to expert centers for desensitization when needed. Vital is the careful selection of patients whose health status is such that desensitizing treatment is less likely to cause serious harm and whose anti-HLA antibody status is such that treatment is likely to accomplish the goal of increasing organ offers with an acceptable final crossmatch. Exciting new developments have re-energized the interest and scope of desensitization in the times ahead.
血型和组织不相容仍然是实现移植的重大障碍。尽管由于血型或组织不相容，不应将任何患者标记为“不可移植”，但应向所有候选人提供关于其预期等待时间的个体化和现实的咨询，以了解其是否适合等待已故供体或配对供体匹配，必要时应及早向专家中心转介进行脱敏治疗。重要的是要仔细选择那些健康状况不太可能因脱敏治疗而导致严重伤害的患者，以及那些 HLA 抗体状况使得治疗有可能实现增加可接受最终交叉配型的器官供应的目标的患者。令人兴奋的新发展重新激发了未来脱敏治疗的兴趣和范围。
