肝脏移植术后体液性排斥反应的研究进展  

Research progress on humoral rejection after liver transplantation

作　　者：徐春扬 宋少华[1] 丁国善[1] 

机构地区：[1]第二军医大学附属长征医院器官移植科,上海200003

出　　处：《解放军医学杂志》2017年第10期920-924,共5页Medical Journal of Chinese People's Liberation Army

基　　金：国家自然科学基金(81671576);上海市卫生和计划生育委员会课题(201640274)~~

摘　　要：体液性排斥反应即抗体介导的排斥反应(AMR),是造成移植物失功的重要因素。针对肾脏移植术后AMR的诊断与治疗,移植专家已经积累了一定经验,但肝脏移植术后AMR近年来才逐渐引起关注。肝脏与肾脏移植术后AMR既有相似也有不同之处,肝脏移植术后AMR包括超急性排斥反应(HAR)、急性排斥反应(AHR)、慢性排斥反应(CHR)及适应状态4种类型。本文对其发生机制及临床诊断要点(临床表现、常用血清学指标以及病理标准等)进行分析,对不同类型肝移植术后AMR的危险因素,以及不同类型肝移植术后AMR的预防和治疗进展进行阐述。Recent studies have shown that humoral rejection, or antibody-mediated rejection（AMR）, is an important risk factor for graft failure. Transplant experts have accumulated some experience on the diagnosis and treatment of AMR after kidney transplantation. However, AMR after liver transplantation has not been fully understood until recently, and its pathogenesis, clinical manifestation, diagnosis and treatment are different from AMR after kidney transplantation. In the research progress, the AMR after liver transplantation was classified into hyper acute rejection, acute humoral rejection, chronic humoral rejection and the state of accommodation. The immunity mechanism of AMR after liver transplantation is also described. The different kinds of AMR after liver transplantation were diagnosed by analyzing the clinical manifestations, serum tests and pathological characteristics of the patients. Moreover, the risk factors of them were mentioned in the article. Then we also introduce the different strategies for prevention and treatment of AMR after liver transplantation. Therefore, based on the current research progress on AMR after liver transplantation, we analyze the future direction of progress.

关 键 词：肝移植 体液免疫 排斥反应 

分 类 号：R657.3[医药卫生—外科学]