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输血前移植后的输血特异性非免疫反应

Katrina J Spensley¹, Sevda Hassan², David J Roberts³

¹Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, Hammersmith Campus, London, UK; Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK.

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

|December 17, 2024

概括

输血可以导致移植患者产生人类白细胞抗原 (HLA) 抗体. 这些输血特异性抗体 (TSA) 与移植排斥率的增加有关,这强调了需要HLA选择血液的需要.

科学领域:

免疫学免疫学免疫学
移植科学移植科学
血液学血液学血液学

背景情况:

众所周知,输血会导致全敏化.
输血后新开发的人类白细胞抗原 (HLA) 抗体通常被认为是不特定的和短暂的.

研究的目的:

为了研究输血对等待移植的患者全敏感化的影响.
检查在等待期和移植后输血特异性抗体 (TSAs) 的发展.

主要方法:

在105名献血者身上进行了HLA类型测定,用于50名候诊列表中的移植患者.
在患者中监测了新的HLA抗体和TSAs的发展.
分析了移植结果,包括排斥率,与移植前的敏感性相关.

主要成果:

62%的患者在输血后出现了新的HLA抗体;34%的患者至少出现了一种TSA.
在23%的以前不敏感的患者和50%的具有先前存在的HLA抗体的患者中发生了TSA的发展.
移植后3个月内新发现TSA的患者在3年内显示出更高的抗体中介排斥率.

结论:

输血对等待名单患者的HLA全敏感化有显著的贡献.
输血特异性抗体与更差的移植结果有关,特别是排斥的增加.
在等待名单上的患者中使用HLA选择血液进行输血可能会改善长期的移植成功.

关键词:

整体敏感化敏感化输血输血输血输血输血他的兼容性与不兼容性.

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