Timofeeva Olga, Brown James
Department of Pathology and Laboratory Medicine, MedStar Georgetown University Hospital, Washington D. C., USA.
Department of Thoracic Medicine, Temple University Hospital, Philadelphia, USA.
Indian J Thorac Cardiovasc Surg. 2022 Jul;38(Suppl 2):248-259. doi: 10.1007/s12055-021-01201-5. Epub 2021 Jul 29.
Lung transplant outcomes remain inferior largely due to mismatching in human leukocyte antigens (HLAs) that leads to chronic rejection and chronic allograft dysfunction. The mismatched donor HLAs can be recognized by the effector T cells or donor-specific HLA antibodies. This review summarizes mechanisms leading to immune responses as a result of HLA mismatching. It specifically focuses on sensitized lung transplant candidates with preformed anti-HLA antibodies, which represent a significant management challenge for physicians. In this review, we describe the diagnostic histocompatibility testing and therapeutic options for managing the sensitized lung transplant patients and discuss how multidisciplinary approach may help to improve lung transplantation outcomes.
肺移植的结果仍然较差，这主要是由于人类白细胞抗原（HLA）不匹配导致慢性排斥反应和慢性移植器官功能障碍。不匹配的供体HLA可被效应T细胞或供体特异性HLA抗体识别。本综述总结了由于HLA不匹配导致免疫反应的机制。它特别关注有预先形成的抗HLA抗体的致敏肺移植候选者，这对医生来说是一个重大的管理挑战。在本综述中，我们描述了用于管理致敏肺移植患者的诊断组织相容性检测和治疗选择，并讨论了多学科方法如何有助于改善肺移植结果。
