PDF(Pubmed)
Abstract：
The formation of antibodies against donor human leukocyte antigens poses a challenging problem both for donor selection as well as postoperative graft function in lung transplantation. These donor-specific antibodies limit the pool of potential donor organs and are associated with episodes of antibody-mediated rejection, chronic lung allograft dysfunction, and increased mortality. Optimal management strategies for clearance of DSAs are poorly defined and vary greatly by institution; most of the data supporting any particular strategy is limited to small-scale retrospective cohort studies. A typical approach to antibody depletion may involve the use of high-dose steroids, plasma exchange, intravenous immunoglobulin, and possibly other immunomodulators or small-molecule therapies. This review seeks to define the current understanding of the significance of DSAs in lung transplantation and outline the literature supporting strategies for their management.
摘要：
针对供体人白细胞抗原的抗体的形成对供体选择以及肺移植中的术后移植物功能都提出了挑战性的问题。这些供体特异性抗体限制了潜在供体器官的库，并与抗体介导的排斥反应有关。慢性肺移植功能障碍，和死亡率增加。清除DSA的最佳管理策略定义不明确，并且因机构而异；支持任何特定策略的大多数数据仅限于小规模回顾性队列研究。抗体消耗的典型方法可能涉及使用高剂量类固醇，血浆置换,静脉注射免疫球蛋白，可能还有其他免疫调节剂或小分子疗法。这篇综述旨在定义目前对DSA在肺移植中的重要性的理解，并概述支持其管理策略的文献。
