在等待名单患者和脏移植接受者中,输血诱导的HLA敏感化
Michelle Willicombe1, David J Roberts2
1Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, London, UK; Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK.
Kidney international
|August 24, 2024
概括
预防人类白细胞抗原 (HLA) 敏感化对于固体器官移植成功至关重要. 这次审查强调了需要在移植中制定患者血液管理指南,以解决输血诱导的HLA敏感性问题.
科学领域:
- 免疫学 免疫学 免疫学
- 移植医学 移植医学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 人类白细胞抗原 (HLA) 敏感性显著阻碍了固体器官移植的机会和长期的移植存活.
- 目前对HLA抗体的治疗方法长期有效性有限,这强调了预防的重要性.
- 尽管慢性病贫血管理方面取得了进展,但红细胞输血的需要仍然存在,特别是在移植方面.
研究的目的:
- 审查目前对输血诱导的HLA敏感性在移植候选人和接受者的知识.
- 确定有关输血实践及其免疫调节效应的证据缺口.
- 强调需要在移植中制定特定的患者血液管理指南.
主要方法:
- 关于输血诱导的HLA敏感性的现有研究的文献综述.
- 分析脏和移植注册表中的输血发生率,指示和结果的数据缺口.
- 关于移植血液输血的异构和免疫调节方面的证据综合.
主要成果:
- 输血,特别是术后输血,在移植患者中很常见.
- 在全球范围内,对输血实践的例行数据收集不足,限制了临床证据.
- 输血的免疫调节和全基因刺激效应需要在HLA敏感化背景下进一步研究.
结论:
- 输血诱导的HLA敏感性仍然是移植的重大临床挑战.
- 迫切需要针对移植接受者量身定制的综合性患者血液管理策略.
- 进一步的研究和标准化的数据收集对于为临床实践提供信息和改善移植结果至关重要.
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