乘客淋巴细胞综合征(PLS)是在ABO不匹配的肾移植后发生的免疫介导的溶血。PLS是由供体淋巴细胞产生受体红细胞抗体引起的,导致溶血。据报道,在ABO不匹配的患者组中,PLS的发生率约为20%。然而,目前尚无肾移植术后PLS的全面审查。在这次审查中,我们系统总结了肾移植术后PLS患者的资料,以帮助临床医生更有效地诊断和治疗。
使用PubMed进行了系统评价,Embase,和WebofScience。收集所有相关数据,包括年龄,性别,以及临床和免疫参数。
共发现91例已发表病例。年龄9~70岁,男性占58.2%。86例只是肾移植,一个是肝肾移植,三个是胰肾移植,一个是肠肾移植。在这些案件中,27人接受了已故捐赠者的肾脏,而40人接受了来自活体捐献者的肾脏。大多数患者表现为以贫血为主的免疫性溶血,对症支持治疗后明显改善,如输血和促红细胞生成素注射。
PLS是一种免疫介导的疾病,可发生在ABO不匹配的肾移植患者中,通常会导致溶血,尽管患有该疾病的患者也可能发生移植物的死亡或畸形。对症支持治疗是目前有效的治疗方案,但仍需要探索更有效的治疗和预防方案。
Passenger lymphocyte syndrome (PLS) is an immune-mediated hemolysis that occurs after ABO-mismatched kidney transplantation. PLS is caused by donor lymphocytes producing antibodies to recipient red blood cells, resulting in hemolysis. The incidence of PLS has been reported to be approximately 20% in patients with ABO-mismatched groups. Nevertheless, there is no comprehensive review of PLS following renal transplantation. In this review, we systematically summarized the data of patients with PLS after renal transplantation to help clinicians diagnose and treat more effectively.
A systematic review was conducted using PubMed, Embase, and Web of Science. All relevant data were collected, including age, sex, and clinical and immune parameters.
A total of 91 published cases were identified. The age ranged from 9 to 70 years old and 58.2% were male. Eighty-six cases were only kidney transplantations, one was liver-kidney transplantation, three were pancreas-kidney transplantations, and one was intestinal-kidney transplantation. Of these cases, 27 received kidneys from deceased donors, whereas 40 received kidneys from living donors. Most patients showed immune hemolysis dominated by anaemia, which was significantly improved after symptomatic support treatment, such as blood transfusion and erythropoietin injection.
PLS is an immune-mediated disease that can occur in patients with ABO-mismatched renal transplantation, which commonly causes hemolysis, although death or deformities of the graft can also occur in patients with the disorder. Symptomatic supportive treatment is an effective treatment scheme at present, but more effective treatment and prevention schemes still need to be explored.