Mizera Jakub, Pilch Justyna, Giordano Ugo, Krajewska Magdalena, Banasik Mirosław
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-551 Wroclaw, Poland.
University Clinical Hospital, Wroclaw Medical University, 50-551 Wroclaw, Poland.
Life (Basel). 2023 Jun 27;13(7):1458. doi: 10.3390/life13071458.
Kidney graft failure is not a homogenous disease and the Banff classification distinguishes several types of graft rejection. The maintenance of a transplant and the treatment of its failure require specific medications and differ due to the underlying molecular mechanism. As a consequence, patients suffering from different rejection types will experience distinct side-effects upon therapy. The review is focused on comparing treatment regimens as well as presenting the latest insights into innovative therapeutic approaches in patients with an ongoing active ABMR, chronic active ABMR, chronic ABMR, acute TCMR, chronic active TCMR, borderline and mixed rejection. Furthermore, the profile of cardiovascular adverse effects in relation to the applied therapy was subjected to scrutiny. Lastly, a detailed assessment and comparison of different approaches were conducted in order to identify those that are the most and least detrimental for patients suffering from kidney graft failure.
肾移植失败并非一种同质化疾病,班夫分类法区分了几种类型的移植排斥反应。维持移植及治疗其失败情况需要特定药物,且因潜在分子机制的不同而有所差异。因此,患有不同排斥类型的患者在治疗时会出现不同的副作用。本综述重点比较了治疗方案,并介绍了在持续性活动性抗体介导的排斥反应(ABMR)、慢性活动性ABMR、慢性ABMR、急性细胞介导的排斥反应(TCMR)、慢性活动性TCMR、临界性和混合性排斥反应患者中创新治疗方法的最新见解。此外,还对与所应用治疗相关的心血管不良反应情况进行了审查。最后,对不同方法进行了详细评估和比较,以确定哪些方法对肾移植失败患者的危害最大和最小。