关于 ABO 不兼容肝移植的策略
Shekhar S Jadaun1, Shaleen Agarwal2, Subhash Gupta2
1Department of Gastroenterology and Hepatology, Centre for Liver and Biliary Sciences, Max Super Speciality Hospital, Saket, New Delhi, India.
Journal of clinical and experimental hepatology
|July 13, 2023
概括
由于改进了无敏化协议,ABO不兼容的活体供体肝移植 (LDLT) 结果现在与ABO兼容的移植相匹配. 新的疗法显示出进一步增强结果和减少肝移植并发症的前景.
科学领域:
- 移植免疫学 移植免疫学
- 肝病学 肝病学是一种肝病学.
- 手术方面的创新.
背景情况:
- 肝移植 (LT) 对于末期肝病至关重要.
- 有限的尸体全移植需要扩大捐赠池,包括ABO不相容 (ABOi) 活体捐赠者.
- 无敏化方案的进步改善了ABOi LDLT的结果.
研究的目的:
- 审查目前的ABO不相容的活体供体肝移植 (ABOi LDLT) 的协议和结果.
- 讨论脱敏疗法在减少抗体中介排斥中的作用.
- 在 ABOi LT. 探索新兴疗法和挑战.
主要方法:
- 审查包括Rituximab,等离子体和免疫吸收在内的脱敏方案.
- 对移植后免疫抑制策略的分析.
- 讨论比拉塔塞普特和奥比努图祖马布等较新的药物.
主要成果:
- ABOi LDLT的结果与当前协议的 ABO 兼容的 LT 相似.
- 利图西马布与异位结合有效降低抗体标位和排斥风险.
- 在移植后的ABOi LDLT中,高水平的塔克罗利斯往往是目标.
结论:
- ABOi LDLT是一种可行的选择,可以扩大捐赠者池,结果与 ABO 兼容的 LT 相匹配.
- 标准化方案和新的疗法对于管理ABOi LT至关重要.
- 紧急ABOi LT提出了独特的挑战,但显示了令人鼓舞的初步结果.
相关概念视频
Blood Transfusion
616
Blood transfusion is a critical medical procedure that saves lives and treats various medical conditions. It involves transferring blood from a donor to a recipient. This process requires a thorough understanding of the ABO blood group system and its associated antigens and antibodies.
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
616
The ABO Blood Group
1.8K
The ABO blood group system is a critical element of transfusion medicine, essential for determining blood compatibility in transfusions and organ transplants. It is based on specific antigens, or agglutinogens, present on the surface of red blood cells (RBCs) and corresponding antibodies, or agglutinins, in the blood plasma.
Antigens in the ABO Blood Group System
Antigens are substances that can trigger an immune response, leading to the production of antibodies. In the ABO blood group system,...
Antigens in the ABO Blood Group System
Antigens are substances that can trigger an immune response, leading to the production of antibodies. In the ABO blood group system,...
1.8K
Blood Transfusion and Agglutination
10.9K
Blood transfusion is a therapeutic measure to restore the blood volume after extensive blood loss due to an accident or a medical procedure. Blood transfusion involves drawing a certain amount of blood from a suitable donor and infusing it into the recipient.
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
10.9K
Bone Marrow Sampling and Transplants
360
Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
360
Tissue Transplantation
408
Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
408
Kidney Transplant I: Introduction
29
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
29


