دورية أكاديمية
أعرض في EDS

Antibody-mediated rejection: prevention, monitoring and treatment dilemmas.

التفاصيل البيبلوغرافية
العنوان: Antibody-mediated rejection: prevention, monitoring and treatment dilemmas.
المؤلفون: Rodriguez-Ramirez S; Department of Medicine, Division of Nephrology.; Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada., Al Jurdi A; Division of Nephrology, Massachusetts General Hospital, Harvard Medical School.; Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA., Konvalinka A; Department of Medicine, Division of Nephrology.; Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada.; Toronto General Hospital Research Institute, University Health Network.; Institute of Medical Science, University of Toronto.; Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada., Riella LV; Division of Nephrology, Massachusetts General Hospital, Harvard Medical School.; Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
المصدر: Current opinion in organ transplantation [Curr Opin Organ Transplant] 2022 Oct 01; Vol. 27 (5), pp. 405-414. Date of Electronic Publication: 2022 Aug 11.
نوع المنشور: Journal Article; Review; Research Support, Non-U.S. Gov't; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9717388 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-7013 (Electronic) Linking ISSN: 10872418 NLM ISO Abbreviation: Curr Opin Organ Transplant Subsets: MEDLINE
أسماء مطبوعة: Publication: <2003->: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Philadelphia, PA : Rapid Science Publishers,
مواضيع طبية MeSH: Graft Rejection*/prevention & control , Kidney Transplantation*/adverse effects, Antibodies ; Biomarkers ; Graft Survival ; Humans ; Isoantibodies ; Plasmapheresis
مستخلص: Purpose of Review: Antibody-mediated rejection (AMR) has emerged as the leading cause of late graft loss in kidney transplant recipients. Donor-specific antibodies are an independent risk factor for AMR and graft loss. However, not all donor-specific antibodies are pathogenic. AMR treatment is heterogeneous due to the lack of robust trials to support clinical decisions. This review provides an overview and comments on practical but relevant dilemmas physicians experience in managing kidney transplant recipients with AMR.
Recent Findings: Active AMR with donor-specific antibodies may be treated with plasmapheresis, intravenous immunoglobulin and corticosteroids with additional therapies considered on a case-by-case basis. On the contrary, no treatment has been shown to be effective against chronic active AMR. Various biomarkers and prediction models to assess the individual risk of graft failure and response to rejection treatment show promise.
Summary: The ability to personalize management for a given kidney transplant recipient and identify treatments that will improve their long-term outcome remains a critical unmet need. Earlier identification of AMR with noninvasive biomarkers and prediction models to assess the individual risk of graft failure should be considered. Enrolling patients with AMR in clinical trials to assess novel therapeutic agents is highly encouraged.
(Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)
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معلومات مُعتمدة: R01 AI143887 United States AI NIAID NIH HHS; 469957 Canada CIHR
المشرفين على المادة: 0 (Antibodies)
0 (Biomarkers)
0 (Isoantibodies)
تواريخ الأحداث: Date Created: 20220811 Date Completed: 20220915 Latest Revision: 20240906
رمز التحديث: 20240906
مُعرف محوري في PubMed: PMC9475491
DOI: 10.1097/MOT.0000000000001011
PMID: 35950887
قاعدة البيانات: MEDLINE
الوصف
تدمد:1531-7013
DOI:10.1097/MOT.0000000000001011