在儿科移植接受者中利用来自捐赠者的无细胞DNA:一个单一中心研究
Daniel Ranch1, Mingwei Fei2, Elisabeth Kincade3,4
1Department of Pediatrics, UT Health San Antonio, San Antonio, Texas, USA.
Pediatric transplantation
|August 7, 2023
概括
来自捐赠者的无细胞DNA (dd-cfDNA) 有效地监测儿科移植排斥和治疗反应. 较高的dd-cfDNA水平表明排斥,在成功治疗后水平下降.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植免疫学 移植免疫学
- 分子诊断学 分子诊断学
背景情况:
- 接受移植的接受者有移植排斥的风险.
- 对排斥的监测对于长期的移植存活至关重要.
- 捐赠者衍生的无细胞DNA (dd-cfDNA) 显示出作为非侵入性生物标志物对全移植损伤的承诺.
研究的目的:
- 评估dd-cfDNA在监测儿科移植排斥的有用性.
- 评估dd-cfDNA水平与排斥状态之间的相关性.
- 为了确定dd-cfDNA在追踪对拒绝治疗的反应中的有效性.
主要方法:
- 研究了一组42名儿科脏移植患者的队列.
- 在代移植活检和排斥治疗之前和之后测量了dd-cfDNA水平.
- 分析了61个全移植活检 (44个为原因,17个监测).
主要成果:
- 在61次活检中,在35次活检中发现了移植拒绝.
- 与没有 (0.24%) 患者相比,排斥患者 (1.2%) 的中位数dd-cfDNA水平显著更高.
- 在抗体介导排斥 (AMR) 中,dd-cfDNA水平最高,并在治疗后降低,表明治疗有效性.
结论:
- dd-cfDNA是识别儿科患者移植排斥的一个有价值的工具.
- dd-cfDNA水平可以有效地监测治疗反应.
- 需要进一步的研究来确定dd-cfDNA在常规移植健康监测中的作用.
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