116.[20221214]Updated management for AMR
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작성자 신호식 작성일23-02-03 14:08 조회498회 댓글0건관련링크
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Review Curr Opin Nephrol Hypertens
. 2023 Jan 1;32(1):13-19. doi: 10.1097/MNH.0000000000000843. Epub 2022 Oct 11.
Updated management for antibody-mediated rejection: opportunity to prolong kidney allograft survival
Natavudh Townamchai 1 2 3, Yingyos Avihingsanon 1 2 3
Affiliations expand
PMID: 36250450 DOI: 10.1097/MNH.0000000000000843
Abstract
Purpose of review: Antibody-mediated rejection (ABMR) is an important barrier to achieve long-term kidney allograft survival. Human leukocyte antibody (HLA)-incompatibility and ABO-incompatibility are the two main mechanisms of ABMR. Nevertheless, the advances in managing ABMR have changed the paradigm for kidney transplantation. This review aimed to emphasize the HLA-incompatibility and ABO-incompatibility kidney transplant and update the management of ABMR.
Recent findings: HLA-incompatibility kidney transplantation is a strong risk factor for ABMR. Donor-specific antibody (DSA) is a surrogate biomarker that prevents long-term allograft survival. The standard treatment for ABMR has unfavorable results. New drugs that target the B cell are a promising approach to treat ABMR. In the past, ABO-incompatibility kidney donor was an absolute contraindication but now, it is widely accepted as an alternative organ resource. The advancement of ABO antibody removal and B-cell depletion therapy has been successfully developed. ABO isoagglutination remains the main biomarker for monitoring ABMR during the transplantation process. C4d staining without inflammation of the kidney allograft is the marker for the accommodation process.
Summary: With the shortage of organ donors, transplant experts have expanded the organ resources and learned how to overcome the immunological barriers by using novel biomarkers and developing new treatments that support long-term graft survival.
Review Curr Opin Nephrol Hypertens
. 2023 Jan 1;32(1):13-19. doi: 10.1097/MNH.0000000000000843. Epub 2022 Oct 11.
Updated management for antibody-mediated rejection: opportunity to prolong kidney allograft survival
Natavudh Townamchai 1 2 3, Yingyos Avihingsanon 1 2 3
Affiliations expand
PMID: 36250450 DOI: 10.1097/MNH.0000000000000843
Abstract
Purpose of review: Antibody-mediated rejection (ABMR) is an important barrier to achieve long-term kidney allograft survival. Human leukocyte antibody (HLA)-incompatibility and ABO-incompatibility are the two main mechanisms of ABMR. Nevertheless, the advances in managing ABMR have changed the paradigm for kidney transplantation. This review aimed to emphasize the HLA-incompatibility and ABO-incompatibility kidney transplant and update the management of ABMR.
Recent findings: HLA-incompatibility kidney transplantation is a strong risk factor for ABMR. Donor-specific antibody (DSA) is a surrogate biomarker that prevents long-term allograft survival. The standard treatment for ABMR has unfavorable results. New drugs that target the B cell are a promising approach to treat ABMR. In the past, ABO-incompatibility kidney donor was an absolute contraindication but now, it is widely accepted as an alternative organ resource. The advancement of ABO antibody removal and B-cell depletion therapy has been successfully developed. ABO isoagglutination remains the main biomarker for monitoring ABMR during the transplantation process. C4d staining without inflammation of the kidney allograft is the marker for the accommodation process.
Summary: With the shortage of organ donors, transplant experts have expanded the organ resources and learned how to overcome the immunological barriers by using novel biomarkers and developing new treatments that support long-term graft survival.
