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在移植患者的协议活检:经过大量讨论后的现行实践
Christina Lazarou1, Eleni Moysidou1,2, Michalis Christodoulou1,2
1School of Medicine, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece.
Biomedicines
|July 29, 2025
概括
协议活检对于监测移植接受者至关重要,可以及早检测诸如拒绝和感染等亚临床问题. 这些监测活检指导治疗,改善长期移植存活率,特别是在高风险患者中.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 移植医学 移植医学 移植医学
- 病理学 病理学 病理学
背景情况:
- 对移植接受者来说,协议活检是必不可少的,因为它可以检测标准检测中遗漏的亚临床问题.
- 它们可以早期识别排斥,慢性损伤,感染 (例如,BK多聚马病毒) 和疾病复发.
研究的目的:
- 评估协议活检在移植管理中的作用和影响.
- 评估早期检测和干预对移植存活的好处.
主要方法:
- 追溯观察性研究和随机对照试验对协议活检的分析.
- 专家意见的审查和关于活检时间,频率和患者选择的共识.
主要成果:
- 协议活检在临床症状出现之前就能检测出亚临床病理,指导干预.
- 活检指导的管理改善了移植功能 (血清肌素,GFR) 和存活率,特别是在高风险组 (ABO/HLA不兼容,复发性疾病).
- 证据支持早期和晚期监测活检用于预测结果.
结论:
- 协议活检对于个性化移植监测,早期发现并发症和优化免疫抑制是有价值的.
- 由于风险,成本和不确定的长期益处,它们在低风险患者的常规使用受到争议.
- 需要进一步进行多中心试验,以完善最佳临床效益的指导方针.
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