Importance of human leukocyte antigen antibodies and leukocyte antigen/killer-cell immunoglobulin-like receptor genes in liver transplantation
作者机构：Immunology ServiceUniversity Clinical Hospital Virgen de la Arrixaca-Biomedical Research Institute of Murcia(IMIB)Murcia 30120Spain Department of Legal and Forensic MedicineBiomedical Research Institute(IMIB)Regional Campus of International Excellence“Campus Mare Nostrum”Faculty of MedicineUniversity of MurciaMurcia 30120Spain
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2023年第29卷第5期
页 面：766-772页
核心收录：
学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学]
基 金：Instituto de Salud Carlos III,Spanish Ministry of Economy and Competitiveness,No.PI15/01370 and P19/01194 and the European Union with the European Fund of Regional Development with the principle of“A manner to build Europe”
主 题：Acute rejection Alloantibodies donor-specific antibodies-donor-specific anti-human leukocyte antigen antibodies Chronic rejection Human leukocyte antigen matching Killer-cell immunoglobulin-like receptor matching Liver transplant
摘 要：Many mechanisms have been proposed to explain the hypothetical state of hepatic tolerance,which is described by eventual imbalances or deregulation in the balance of cytokines,mediators,effectors,and regulatory cells in the complex milieu of the *** this section,we will comment on the importance of donorspecific anti-human leukocyte antigen(HLA)antibodies(DSA)as well as the compatibility and pairings of HLA and killer-cell immunoglobulin-like receptor(KIR)genotypes in the evolution of liver ***,HLA compatibility,viral infections,and HLA-C/KIR combinations have all been linked to liver transplant rejection and *** have been reports of increased risk of acute and chronic rejection with ductopenia,faster graft fibrosis,biliary problems,poorer survival,and even de novo autoimmune hepatitis when DSAs are present in the *** mean fluorescence intensity(MFI)values of the DSAs and smaller graft size were associated with poorer patient outcomes,implying that high-risk patients with preformed DSAs should be considered for selecting the graft placed and desensitization methods,according to the ***,in a combined kidney-liver transplant,a pretransplant with a visible expression of several DSAs revealed that these antibodies were resistant to *** renal graft was lost owing to antibody-mediated rejection(AMR).The HLA antigens expressed by the transplanted liver graft influenced antibody *** are increasingly diagnosing AMR in liver transplants,and desensitization therapy has even been employed in situations of AMR,particularly in patients with DSAs in kidney-hepatic transplants and high-class II MFI due to *** conclusion,after revealing the negative impacts of DSAs with high MFI,pretransplant virtual crossmatch techniques may be appropriate to improve evolution;however,they may extend cold ischemia periods by requiring the donor to be typed.
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