高致敏肾移植受者脱敏治疗的研究进展  

Research progress on desensitization therapy for highly sensitized kidney transplant recipients

作　　者：徐岳[1] 胡小鹏[1] Xu Yue;Hu Xiaopeng(Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院,100020

出　　处：《器官移植》2021年第6期676-681,共6页Organ Transplantation

基　　金：国家自然科学基金(81970645)。

摘　　要：人类白细胞抗原(HLA)致敏在过去被认为是肾移植的禁忌证,在过去的30年中,随着脱敏治疗策略和免疫抑制剂的不断进步,越来越多的高致敏患者跨过了这一障碍。然而,高致敏患者肾移植术后仍面临着较高的超急性排斥反应以及抗体介导的排斥反应发生率,制约着高致敏患者肾移植手术的成功及移植物的长期存活。寻找切实有效的脱敏治疗方案是目前器官移植研究的热点问题,本文将从目前的脱敏治疗策略、用于脱敏治疗的新型制剂以及脱敏治疗的获益与风险进行综述,对目前脱敏治疗的方法以及脱敏治疗未来的方向进行讨论,旨在为跨越免疫屏障、提高高致敏患者肾移植手术的成功率及术后受者生活质量提供参考。Human leukocyte antigen(HLA)sensitization has been previously considered as a contraindication for kidney transplantation.In the past 30 years,with the development of desensitization therapy strategies and immunosuppressants,more and more highly sensitized patients have been eligible for kidney transplantation.However,highly sensitized patients still face a high incidence of hyperacute rejection and antibody-mediated rejection following kidney transplantation,which restricts the success of kidney transplantation and long-term graft survival.At present,exploring effective desensitization regimen is a hot spot in the research of organ transplantation.In this article,the current desensitization therapy strategies,new preparations for desensitization therapy,and the benefits and risks of desensitization therapy were reviewed,and the current status and future direction of desensitization therapies were investigated,aiming to provide reference for resolving the immune barrier,improving the success rate of kidney transplantation and enhancing the quality of life of highly sensitized recipients.

关 键 词：肾移植 脱敏治疗 利妥昔单抗 静脉注射免疫球蛋白 IgG肽链内切酶 硼替佐米 依库珠单抗 托珠单抗 

分 类 号：R617[医药卫生—外科学] R392.4[医药卫生—临床医学]