接种疫苗的患者在欧洲移植脏分配系统中面临着减少移植的机会
Hans de Ferrante1,2, Bart Smeulders1, Ineke Tieken2
1Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, the Netherlands.
Transplantation
|June 9, 2023
概括
具有不可接受抗原的移植候选人面临着明显较低的移植率. 欧洲移植脏分配系统 (ETKAS) 对这些高度敏感的患者提供了不充分的补偿,影响了获得拯救生命的移植的机会.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
- 移植科学 移植科学
背景情况:
- 捐赠者特定的HLA抗体会对移植结果产生负面影响.
- 可以将不可接受的抗原分配给Eurotransplant移植候选人,以避免引起HLA抗体的报价.
- 本研究评估了不可接受的抗原对欧洲移植脏分配系统 (ETKAS) 中移植访问的影响.
研究的目的:
- 评估不可接受的抗原在ETKAS中影响移植访问的程度.
- 量化虚拟面板反应性抗体 (vPRA) 与移植率之间的关系.
主要方法:
- 在2016-2020年期间,对19,240名脏移植接受者进行了回顾性队列研究.
- 考克斯回归分析用于评估相对移植率与vPRA之间的关联.
- 模型按国家和血型分层,并根据各种患者和供体因素进行调整.
主要成果:
- 随着vPRA水平的增加,移植率显著下降 (vPRA0.1-50%下降23%,75-85%下降51%).
- 观察到vPRA>85%的移植率迅速下降.
- 移植率和vPRA之间的反向关系独立于分配系统变量,表明当前的ETKAS分配不充分补偿免疫患者.
结论:
- 免疫移植候选人经历了欧洲移植中移植率的降低.
- 目前的ETKAS分配系统没有充分解决免疫患者面临的移植机会减少的问题.
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