供体特异性抗体在肾移植中的诊治进展  

Current Diagnosis and Therapy States of Donor Specific Antibodies in Kidney Transplantation

作　　者：杨勇 王伟[2] 司晶[3] 李志军[3] 舒涛[3] 叶啟发[2,3] 

机构地区：[1]湖北省宜昌市夷陵医院,湖北宜昌443100 [2]中南大学湘雅三医院/卫生部移植医学工程技术研究中心,湖南长沙410013 [3]武汉大学中南医院/武汉大学肝胆疾病研究院/武汉大学移植医学中心/移植医学技术湖北省重点实验室,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2016年第4期640-646,共7页Medical Journal of Wuhan University

摘　　要：随着免疫抑制剂的不断更新及应用,抗体介导的排斥反应(AMR)正逐渐成为肾移植术后排斥反应发生的主要类型,其发生与供体特异性抗体(DSA)存在密切的关系。DSA不但能介导急性AMR,也能介导慢性排斥反应,此外,即使术前淋巴细胞毒交叉配型阴性结果的患者,也不能排除AMR的发生。所以对于肾移植术后的排斥反应,应特别关注其是否由DSA引起。本文就供体特异性抗体(DSA)概念、DSA介导的AMR发生的机制、DSA介导的AMR诊断、DSA介导的AMR治疗及预防策略进行综述,以期有助于后续的临床和实验研究。Along with the continuous renewal and application of immunosuppressant,antibody-mediated rejection（AMR）is gradually becoming the main type of rejection occurred after kidneytransplantation,and its occurrence has a close relationship with the donor specific antibody（DSA）.DSA could not only mediateacute AMR,but also can mediate chronic rejection,in addition,even if the patients＇ preoperative lymphocyte poison cross match are negative,AMR cannot be entirely ruled out.So,special attention should be paid to whether the rejection after kidney transplantation is caused by DSA.In this paper,the concept of DSA,the mechanism of DSA mediated AMR,the diagnosis of DSA mediated AMR,the treatment and prevention strategy of DSA mediated AMR will be reviewed,looking forward to help the follow-up clinical and experimentalresearch.

关 键 词：抗体介导的排斥反应 供体特异性抗体 肾移植 

分 类 号：R392.45[医药卫生—免疫学] R699.2[医药卫生—基础医学]