在跨性别血管化复合性全移植中免疫学考虑和结果
Nicole E James1, Curtis L Cetrulo2, Alexandre G Lellouch2,3,4,5
1Department of Plastic and Reconstructive Surgery, John Radcliffe Hospital, Oxford, UK.
Clinical transplantation and research
|December 3, 2025
概括
跨性别血管化复合性全体移植 (VCA) 显示出扩大捐赠池的前景. 女性对男性的移植有良好的结果,尽管有拒绝情节,但大多数异位移植都存活下来.
科学领域:
- 移植免疫学 移植免疫学
- 重建性手术是一种重建性手术.
- 器官移植 器官移植 器官移植
背景情况:
- 血管化复合性全体移植 (VCA) 对严重组织缺陷至关重要,但面临着供体短缺的问题.
- 跨性别VCA (CS-VCA) 可以扩大捐赠者池,但仍然存在对拒绝风险增加的担忧.
- 本综述分析了成人CS-VCA病例,以评估结果和风险.
研究的目的:
- 评估成年接受者的跨性别VCA (CS-VCA) 的可行性和结果.
- 分析急性排斥,异种移植存活率和CS-VCA中的并发症.
- 为了确定人类白细胞抗原 (HLA) 匹配对CS-VCA成功的影响.
主要方法:
- 系统审查已公布的成人CS-VCA病例,截至2025年5月.
- 分析主要结果,包括急性排斥,异种移植存活率和免疫性并发症.
- 结果与人类白细胞抗原 (HLA) 不匹配水平的相关性.
主要成果:
- 审查了九个CS-VCA病例 (六个上肢,一个下肢,两个腹壁).
- 在九例中,有五例经历了急性排斥,但在13例全移植中,有11例在免疫抑制下存活 (6-41个月的随访).
- 较高的HLA不匹配与并发症相关;较少的不匹配与更好的结果相关.
结论:
- 女性对男性的CS-VCA在这个有限的系列中表现出相对有利的结果.
- CS-VCA可能是一个可行的策略,通过仔细的患者选择和HLA匹配来扩大VCA捐赠池.
- 需要对性别特异性免疫反应进行进一步的研究,以优化长期的CS-VCA成功.
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