Buc M
Imunologický ústav Lekárskej fakulty UK, Bratislava.
Vnitr Lek. 1993 Oct;39(10):988-94.
Progress in comprehension of the immunogenetics of the HLA-complex and the discovery of new very potent immunosuppressive agents have enabled organ and tissue transplantations to be performed as a relatively routine therapeutic method. Long-term outcome measured as a half-life in kidney transplantations is 25 years among HLA-identical siblings, 12 years in one haplotype-mismatched paternal donors, and 7 years in cadaver transplantation program. The long-term outcome in the latter group can be markedly improved--to as much as 19 years--when six-antigen program is observed (i.e. donor and recipient are identical in HLA-DR, -B, and -A antigens). The survival of patients after bone marrow transplantation (BMT) having as a donor a HLA-identical sibling has improved remarkably, too. However, only about 30 percent of patients who might benefit from a bone marrow transplant have a genotypically. HLA-identical sibling who could be a donor. Transplants from unrelated donors have become therefore an alternative method. To find HLA-matched donors the establishment of large registries are needed. One of them--Them Bone Marrow Donors Worldwide--in Leiden has over 1.2 million of potential donors at the time being (1992).
对HLA复合体免疫遗传学理解的进展以及新型高效免疫抑制剂的发现，使得器官和组织移植能够作为一种相对常规的治疗方法得以开展。以肾移植的半衰期来衡量的长期预后情况是：在HLA完全相同的同胞之间进行移植，半衰期为25年；在单倍型不匹配的父系供体移植中为12年；在尸体供体移植项目中为7年。在尸体供体移植组中，如果遵循六抗原方案（即供体和受体在HLA-DR、-B和-A抗原上完全相同），长期预后情况可显著改善，长达19年。以HLA完全相同的同胞作为供体进行骨髓移植（BMT）后患者的生存率也有显著提高。然而，可能从骨髓移植中受益的患者中，只有约30%有基因分型上HLA完全相同的同胞可作为供体。因此，来自非亲属供体的移植已成为一种替代方法。为了找到HLA匹配的供体，需要建立大型登记库。其中之一——位于莱顿的全球骨髓供体登记库——在1992年时已有超过120万潜在供体。
