常规脏移植后抗HLA抗体查的实用性
Sofiane Salhi1,2, Nicolas Congy-Jolivet2,3,4, Anne-Laure Hebral1
1Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.
Kidney international reports
|May 6, 2024
概括
系统性查de novo捐赠者特异性抗体 (dnDSA) 很少在第一年后在低风险移植患者中检测到这些抗体. 临床指示测试在早期抗体中介排斥 (AMR) 检测方面似乎比常规年度查更有影响力.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 移植免疫学 移植免疫学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 新生供体特异性抗体 (dnDSA) 是抗体中介排斥 (AMR) 和移植中移植损失的关键指标.
- 尽管成本高昂,但一些机构建议进行系统的年度dnDSA查,但其临床效用仍然不确定.
研究的目的:
- 通过系统查评估dndsa检测的发病率和临床实用性,与低免疫风险脏移植接受者的临床指示测试相比.
主要方法:
- 对1072名脏移植患者的回顾性分析 (低风险:非HLA敏感,没有先前的移植).
- 根据测试理由 (系统性与临床上指示) 评估dNDSA发生率.
- 随访期为8年 (IQR:5-11) 进行了4611次抗HLA测试.
主要成果:
- dnDSA在7.2%的患者中发展; 45.5%在第一年内被检测出来.
- 系统查仅在1.08%的测试中检测到dnDSA.
- 在系统的DSA测试 (17.9%和15.4%) 后,活检中经常出现活跃和慢性AMR.
结论:
- 在低风险移植患者的系统dndsa查中,很少发现dndsa,特别是在第一年后.
- 临床指示测试在早期检测AMR中似乎比常规年度查在这个人群中更有效.
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