在已故捐赠者脏移植交叉匹配中选择性消除和基于细胞的试验的合理化
Myriam Khalili1,2, Olusegun Famure1, Michelle Minkovich1
1Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Transplantation direct
|March 11, 2024
概括
在已故捐赠者的移植中消除常规的移植后流细胞计交叉匹配 (FCXM) 是安全而有效的. 这种方法仅依赖于虚拟交叉匹配,保持低抗体中介排斥率 (AMR) 和优化资源使用.
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
- 临床移植 临床移植
背景情况:
- 在移植中,越来越多人依赖虚拟交叉匹配.
- 传统实践通常涉及移植后的流动细胞计交叉匹配 (FCXM).
- 自2018年以来,中心取消了移植前的身体交叉匹配和移植后的系统性FCXM.
研究的目的:
- 评估消除追溯FCXMs的影响.
- 评估死者捐赠移植对资源利用的影响.
- 在移植后3个月内确定移植结果,特别是抗体介导排斥 (AMR).
主要方法:
- 从2018年6月到2021年3月,对358名已故捐赠移植者的回顾性研究.
- 大约70%的移植没有进行任何FCXM.
- 政策实施前和后的AMR发病率的比较.
主要成果:
- 观察到AMR的发病率较低 (9.63/1000人/月).
- 与前三年期间相比,抗菌药物耐药性率相对有利 (每1000人月4.82人,P=0.21).
- 在大多数移植中成功实施政策.
结论:
- 消除追溯FCXM对于脏分配是安全和有效的.
- 完全依赖虚拟交叉匹配是一个可行的策略.
- 支持转向在移植中更简单的交叉匹配协议.
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