1 Division of Transplant Surgery Department of Surgery Johns Hopkins University School of Medicine Baltimore, MD 2 Multi-Organ Transplant Program McGill University Health Center Montreal, Quebec, Canada 3 Department of Epidemiology Johns Hopkins School of Public Health Baltimore, MD.
[Show abstract][Hide abstract] ABSTRACT: Sensitization to human leukocyte antigens (HLA) creates significant barriers for renal transplant candidates, reducing access to transplantation by limiting donor availability and increasing the risk of rejection. Sensitized patients also endure longer wait-times on dialysis. Desensitization protocols, kidney-paired donation, and a combination of both of these modalities have been used to remove or circumvent the clinically deleterious anti-HLA antibodies. Technical advances in antibody characterization methods and therapies targeting the humoral arm of the immune system have facilitated successful transplantation for these immunologically challenging patients. However, antibody-mediated rejection and transplant glomerulopathy resulting from injury to the vascular endothelium are major impediments to further improvement in outcomes. This review describes the assessment protocols, antibody monitoring techniques, and therapeutic strategies that have been used effectively to overcome HLA incompatibility.
[Show abstract][Hide abstract] ABSTRACT: Innovative and exciting advances in the clinical science in solid organ transplantation continuously realize as the results of studies, clinical trials, international conferences, consensus conferences, new technologies and discoveries. This review will address to the full spectrum of news in transplantation, that verified by 2013. The key areas covered are the transplantation activity, with particular regards to the donors, the news for solid organs such as kidney, pancreas, liver, heart and lung, the news in immunosuppressive therapies, the news in the field of tolerance and some of the main complications following transplantation as infections and cancers. The period of time covered by the study starts from the international meetings held in 2012, whose results were published in 2013, up to the 2013 meetings, conferences and consensus published in the first months of 2014. In particular for every organ, the trends in numbers and survival have been reviewed as well as the most relevant problems such as organ preservation, ischemia reperfusion injuries, and rejections with particular regards to the antibody mediated rejection that involves all solid organs. The new drugs and strategies applied in organ transplantation have been divided into new way of using old drugs or strategies and drugs new not yet on the market, but on phase Ito III of clinical studies and trials.
12/2014; 4(4):243-66. DOI:10.5500/wjt.v4.i4.243
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