来自捐赠者的无细胞DNA和脏移植中的活性排斥
Edwin Fernando1, Harshavardhan Trichy Sanathkumar1, Aravind Ramanathan1
1Department of Nephrology Government Stanley Medical College and Hospital Chennai, Tamil Nadu, India.
Indian journal of nephrology
|October 2, 2023
概括
在印度,捐赠者衍生的无细胞DNA (dd-Cf-DNA) 在检测异种移植排斥方面表现有前途. 这种非侵入性标志物有效排除了抗体介导排斥和更高级的T细胞介导排斥.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 移植免疫学 移植免疫学
- 分子诊断学 分子诊断
背景情况:
- 脏异构移植排斥是移植损失的主要原因,需要早期检测.
- 目前的检测依赖于侵入性组织病理学,突出显示了对非侵入性标记物的需求.
- 捐赠者衍生的无细胞DNA (dd-Cf-DNA) 是一种新兴的非侵入性生物标志物,用于预测排斥.
研究的目的:
- 调查dd-Cf-DNA的实用性,作为预测印度人口异位移植排斥的工具.
- 在临床环境中评估dd-Cf-DNA的诊断准确性.
- 确定dd-Cf-DNA作为移植监测的可靠的非侵入性标记物.
主要方法:
- 一项试点研究包括了因功能障碍而接受移植活检的患者和稳定的移植功能患者.
- 采集受体血和捐献者血液进行dd-Cf-DNA分析.
- 进行了dd-Cf-DNA的量化,与活检结果的相关性以及统计分析 (灵敏度,特异性,PPV,NPV,ROC).
主要成果:
- 在31名患者中,12名患者有活性排斥,8名患者有非排斥的功能障碍原因.
- dd-Cf-DNA在预测抗体中介排斥 (ABMR) 和T细胞中介排斥 (TCMR) 1B等级方面表现出高准确性.
- 该测试显示ABMR和TCMR 1B的预测值为100%负,任何排斥的预测值为81%.
结论:
- dd-Cf-DNA是诊断活性异位移植排斥的宝贵工具,特别是ABMR和更高度的TCMR.
- 这项研究是首次报告DD-Cf-DNA在印度的诊断准确性.
- dd-Cf-DNA 作为一种有效的排除测试,用于特定的排斥类型,但对于TCMR等级1A,其准确性较低.
相关概念视频
01:28Kidney Transplant I: Introduction
14
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...
14
01:26Kidney Transplant II: Surgical Procedure
22
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
22
01:22Bone Marrow Sampling and Transplants
352
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...
352
01:40Cell-mediated Immune Responses
68.7K
Overview
68.7K
01:16Kidney Transplant III: Nursing Management
23
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
23
01:24Tissue Transplantation
391
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...
391