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抗体介导的排斥反应和原发性疾病复发:腹部肾、肝和胰腺移植中的两大主要障碍。

Antibody-Mediated Rejection and Recurrent Primary Disease: Two Main Obstacles in Abdominal Kidney, Liver, and Pancreas Transplants.

作者信息

Nakamura Tsukasa, Shirouzu Takayuki

机构信息

Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kamigyo-ku, Kyoto 602-8566, Japan.

Molecular Diagnositcs Division, Wakunaga Pharmaceutical Co., Ltd., 13-4 Arakicho, shinjyuku-ku, Tokyo 160-0007, Japan.

出版信息

J Clin Med. 2021 Nov 19;10(22):5417. doi: 10.3390/jcm10225417.

Abstract

The advances in acute phase care have firmly established the practice of organ transplantation in the last several decades. Then, the next issues that loom large in the field of transplantation include antibody-mediated rejection (ABMR) and recurrent primary disease. Acute ABMR is a daunting hurdle in the performance of organ transplantation. The recent progress in desensitization and preoperative monitoring of donor-specific antibodies enables us to increase positive outcomes. However, chronic active ABMR is one of the most significant problems we currently face. On the other hand, recurrent primary disease is problematic for many recipients. Notably, some recipients, unfortunately, lost their vital organs due to this recurrence. Although some progress has been achieved in these two areas, many other factors remain largely obscure. In this review, these two topics will be discussed in light of recent discoveries.

摘要

在过去几十年中,急性期护理的进展稳固地确立了器官移植的实践。接下来,移植领域中凸显的问题包括抗体介导的排斥反应(ABMR)和原发性疾病复发。急性ABMR是器官移植过程中一个艰巨的障碍。脱敏和供体特异性抗体术前监测方面的最新进展使我们能够提高阳性结果。然而,慢性活动性ABMR是我们目前面临的最重大问题之一。另一方面,原发性疾病复发对许多受者来说是个难题。值得注意的是,一些受者不幸因这种复发失去了重要器官。尽管在这两个领域已经取得了一些进展,但许多其他因素在很大程度上仍然不明朗。在本综述中,将根据最近的发现对这两个主题进行讨论。

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