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中华移植杂志(电子版) ›› 2019, Vol. 13 ›› Issue (04) : 319 -322. doi: 10.3877/cma.j.issn.1674-3903.2019.04.015

所属专题: 文献

综述

胰肾联合移植的HLA配型
刘静1, 李立1, Shifeng Li2,()   
  1. 1. 650000 昆明市第一人民医院器官移植中心
    2. 73104 美国俄克拉荷马州,美国俄克拉荷马大学医学中心 俄克拉荷马移植中心
  • 收稿日期:2019-08-13 出版日期:2019-11-25
  • 通信作者: Shifeng Li
  • 基金资助:
    云南省卫生厅项目(2017NS082)

HLA typing for spontaneous pancreas-kidney transplantation

Jing Liu1, Li Li1, Shifeng Li2,()   

  1. 1. Organ Transplant Center, The First People Hospital in Kunming, Kunming 650000, China
    2. Oklahoma University Medical Center, Oklahoma Transplantation Center, Oklahoma 73104, USA
  • Received:2019-08-13 Published:2019-11-25
  • Corresponding author: Shifeng Li
  • About author:
    Corresponding author: Li Shifeng, Email:
引用本文:

刘静, 李立, Shifeng Li. 胰肾联合移植的HLA配型[J]. 中华移植杂志(电子版), 2019, 13(04): 319-322.

Jing Liu, Li Li, Shifeng Li. HLA typing for spontaneous pancreas-kidney transplantation[J]. Chinese Journal of Transplantation(Electronic Edition), 2019, 13(04): 319-322.

胰肾联合移植术后排斥反应,尤其是抗体介导的排斥反应,是导致移植物丢失的主要原因之一。HLA配型是减少器官移植术后受者免疫系统对移植物损伤的重要保障。通过HLA配型,尤其是HLA分子配型,可帮助临床选择适合的供器官,以预防和避免受者在移植后发生排斥反应;同时,可预估移植后发生排斥反应的风险,从而及时调整免疫抑制方案,使移植器官功能恢复正常。本文就近年来HLA配型在胰肾联合移植中的作用,以及临床上如何根据HLA配型选用胰肾联合移植供器官作一综述。

Rejection after spontaneous pancreas and kidney transplantation (SPK), especially the antibody-mediated rejection, is the main cause of allografts loss. Human leukocyte antigen (HLA) typing plays a crucial role in defense against the injury to the allograft by immune system of recipients. HLA antigen typing, especially the HLA molecular typing, could help to choose a compatible allograft for transplantation; and it might have a role in preventing and circumventing rejection, predicting the risk of immunogenicity posttransplantation, as well as guiding posttransplant immunosuppression strategies; thus, improving the allograft function. This paper tries to discuss the reseach progress of the function of HLA typing in SPK and clinical application of HLA typing for organ selection in SPK.

1
Gruessner AC, Gruessner RW. Long-term outcome after pancreas transplantation: a registry analysis[J]. Curr Opin Organ Transplant, 2016,21(4):377-385.
2
Jenssen T, Hartmann A, Birkeland KI. Long-term diabetes complications after pancreas transplantation[J]. Curr Opin Organ Transplant, 2017,22(4):382-388.
3
Heilman RL, Mazur MJ, Reddy KS. Immunosuppression in simultaneous pancreas-kidney transplantation: progress to date[J]. Drugs, 2010,70(7):793-804.
4
Zhang R. Donor-specific antibodies in kidney transplant recipients[J]. Clin J Am Soc Nephrol, 2018,13(1):182-192.
5
Mittal S, Page SL, Friend PJ, et al. De novo donor-specific HLA antibodies: biomarkers of pancreas transplant failure[J]. Am J Transplant, 2014,14(7):1664-1671.
6
Rudolph EN, Dunn TB, Mauer D, et al. HLA-A, -B, -C, -DR, and -DQ matching in pancreas transplantation: effect on graft rejection and survival[J]. Am J Transplant, 2016,16(8):2401-2412.
7
Salvalaggio PR, Graff RJ, Pinsky B, et al. Crossmatch testing in kidney transplantation: patterns of practice and associations with rejection and graft survival[J]. Saudi J Kidney Dis Transpl, 2009,20(4):577-589.
8
Montgomery RA, Tatapudu VS, Leffell MS, et al. HLA in transplantation[J]. Nat Rev Nephrol, 2018,14(9):558-570.
9
Wiebe C, Nickerson P. Human leukocyte antigen mismatch and precision medicine in transplantation[J]. Curr Opin Organ Transplant, 2018,23(4):500-505.
10
Sypek M, Kausman J, Holt S, et al. HLA epitope matching in kidney transplantation: an overview for the general nephrologist[J]. Am J Kidney Dis, 2018,71(5):720-731.
11
Wiebe C, Kosmoliaptsis V, Pochinco D, et al. A comparison of HLA molecular mismatch methods to determine HLA immunogenicity[J]. Transplantation, 2018,102(8):1338-1343.
12
Daniёls L, Naesens M, Bosmans JL, et al. The clinical significance of epitope mismatch load in kidney transplantation: A multicentre study[J]. Transpl Immunol, 2018,50:55-59.
13
Duquesnoy RJ. Are we ready for epitope-based HLA matching in clinical organ transplantation?[J]. Transplantation, 2017,101(8):1755-1765.
14
McCaughan JA, Tinckam KJ. Donor specific HLA antibodies & allograft injury: mechanisms, methods of detection, manifestations and management[J]. Transpl Int, 2018,31(10):1059-1070.
15
Devos JM, Gaber AO, Teeter LD, et al. Intermediate-term graft loss after renal transplantation is associated with both donor-specific antibody and acute rejection[J]. Transplantation, 2014,97(5):534-540.
16
Williams RC, Opelz G, McGarvey CJ, et al. The risk of transplant failure with HLA mismatch in first adult kidney allografts from deceased donors[J]. Transplantation, 2016,100(5):1094-1102.
17
Berney T, Malaise J, Morel P, et al. Impact of HLA matching on the outcome of simultaneous pancreas-kidney transplantation[J]. Nephrol Dial Transplant, 2005,20 (Suppl 2): ii48-ii53.
18
Kandaswamy R, Stock PG, Gustafson SK, et al. OPTN/SRTR 2016 Annual Data Report: Pancreas[J]. Am J Transplant, 2018,18 (Suppl 1):114-171.
19
Jucaud V. The immunogenicity of HLA class Ⅱ mismatches: the predicted presentation of nonself allo-HLA-derived peptide by the HLA-DR phenotype of the recipient is associated with the formation of DSA[J]. J Immunol Res, 2017: 2748614.
20
Cross AR, Lion J, Loiseau P, et al. Donor specific antibodies are not only directed against HLA-DR: minding your Ps and Qs[J]. Human immunology, 2016,77(11):1092-1100.
21
Cantarovich D, De Amicis S, Akl A, et al. Posttransplant donor-specific anti-HLA antibodies negatively impact pancreas transplantation outcome[J]. Am J Transplant, 2011,11(12):2737-2746.
22
Tambur AR. Human leukocyte antigen matching in organ transplantation: what we know and how can we make it better (Revisiting the past, improving the future)[J]. Curr Opin Organ Transplant, 2018,23(4):470-476.
23
Heilman RL, Chakkera H, Mazur M, et al. Outcomes of simultaneous kidney-pancreas transplantation with positive cross-match[J]. Transplant Proc, 2009,41(1):303-306.
24
Wiebe C, Rush DN, Nevins TE, et al. Class Ⅱeplet mismatch modulates tacrolimus trough levels required to prevent donor-specific antibody development[J]. J Am Soc Nephrol, 2017,28(11):3353-3362.
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