活体供体肝移植使用ABO不兼容的移植用于慢性和急性肝衰竭
Toru Ikegami1, Masashi Tsunematsu2, Kenei Furukawa2
1Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, 105-8461, Japan. toruikegamijikei@jikei.ac.jp.
抗CD20抗体利图西马布 (Rituximab) 彻底改变了ABO不兼容的活体供体肝移植 (ABOi-LDLT),使其成为末期肝病的主要治疗方法. 然而,在ABOi-LDLT中管理急性肝衰竭和抗体中介排斥需要复杂的策略.
科学领域:
- 免疫学 免疫学 免疫学
- 移植医学 移植医学
- 肝病学 肝病学是一种肝病学.
背景情况:
- 在历史上,ABO不兼容的活体供体肝移植 (ABOi-LDLT) 受到抗体介导排斥的限制.
- 通过引入Rituximab (抗CD20抗体),通过向B细胞,显著改善了结果.
- 现在,ABOi-LDLT是末期肝病的首选选择.
研究的目的:
- 审查目前对ABOi-LDLT的战略.
- 讨论急性肝衰竭中ABOi-LDLT的管理.
- 为应对在移植后诊断和治疗抗体介导排斥 (AMR) 的挑战.
主要方法:
- 审查关于ABOi-LDLT和AMR治疗的现有文献.
- 讨论Rituximab在脱敏化方案中的作用.
- 对管理异凝聚素标位和AMR的辅助疗法的分析.
主要成果:
- 利图西马布使ABOi-LDLT成为慢性肝病的标准程序.
- 对于急性肝衰竭病例,需要使用IVIG或博尔特佐米布的专用方案.
- 在ABOi-LDLT中对AMR的最佳治疗策略仍在研究中.
结论:
- 利图西马布已经改变了ABOi-LDLT,但仍然存在挑战,特别是在急性肝衰竭和AMR中.
- 需要进一步的研究来完善ABOi-LDLT的AMR治疗方案.
- ABOi-LDLT是一种可行且越来越常见的肝移植选择.
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