肺移植后怀孕:TRIGGER研究对抗人类白细胞抗原的配免疫和抗体介导的排斥风险
Angélique Leclerc1, Isabelle Danner-Boucher1, Alexandre Walencik2
1Nantes Université, CHU Nantes, Pneumology Department, l'institut du Thorax, Nantes, France.
概括
肺移植后的怀孕具有抗体中介排斥的高风险. 这项研究发现,6.6%的怀孕导致排斥,导致移植损失,并强调需要对这些高风险患者进行仔细监测.
科学领域:
- 移植免疫学 移植免疫学
- 生殖医学是一种生殖医学.
- 肺部病理学 肺部病理学
背景情况:
- 肺移植接受者的怀孕是高风险的,因为伴随性疾病.
- 怀孕可能导致抗人类白细胞抗原 (HLA) 配免疫,可能导致抗体介导排斥 (AMR).
- 怀孕后AMR的风险尚未在接受肺移植的患者中进行研究.
研究的目的:
- 调查肺移植受体在怀孕后一年内发生抗体中介排斥的风险.
- 评估该人口中怀孕后非免疫接种的发生率.
主要方法:
- 跨11个法国肺移植中心的多中心回顾性研究.
- 包括2012年1月1日至2021年12月31日期间怀孕的肺移植接受者.
- 对怀孕结果和怀孕后AMR发生率的分析.
主要成果:
- 分析了52名患者的76例怀孕;大多数接受者因囊性纤维化或肺高血压而进行了双重肺移植.
- 在怀孕后一年内发生了5例抗体中介排斥 (6.6%),所有这些都导致了移植损失 (2例死亡,3例再移植).
- 19例怀孕 (25%) 导致非免疫接种,AMR发生在所有 de novo 供体特异性抗体的病例中.
结论:
- 在女性肺移植接受者中,怀孕与怀孕后一年内幽默排斥的风险增加有关.
- 在怀孕期间和之后,对肺移植接受者进行密切的AMR和免疫监测至关重要.
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