Abstract
The role of antibody-mediated rejection in predicting survival among heart recipients has been studied in clinical transplantology for over 20 years. This condition is a significant risk factor for heart failure and graft vasculopathy. Antibody-mediated rejection results from activation of the humoral immune system and production of donorspecific antibodies that cause myocardial injury through the complement system. The presence of donor-specific antibodies is associated with lower allograft survival. Treatment of antibody-mediated rejection should take into account the rejection category and the presence or absence of graft dysfunction. The main principle of treatment is to suppress humoral immunity at different levels. World clinical practice has made significant inroads into the study of this issue. However, further research is required to identify and develop optimal treatment regimens for patients with humoral rejection in cardiac transplantation.
Highlights
The role of antibody-mediated rejection in predicting survival among heart recipients has been studied in clinical transplantology for over 20 years
The presence of donor-specific antibodies is associated with lower allograft survival
Treatment of antibody-mediated rejection should take into account the rejection category and the presence or absence of graft dysfunction
Summary
The role of antibody-mediated rejection in predicting survival among heart recipients has been studied in clinical transplantology for over 20 years. This condition is a significant risk factor for heart failure and graft vasculopathy. Потребовалось около 25 лет для признания антителоопосредованного отторжения (гуморальное отторжение; AMR) самостоятельным заболеванием, разработки критериев диагностики и схем лечения [1]. Для постановки диагноза антителоопосредованного отторжения требуется наличие клинических проявлений дисфункции трансплантата, морфологических изменений при ЭМБ в виде повреждения микрососудов, обусловленного преимущественно отложением компонента комплемента С4d, а также наличие циркулирующих донор-специфических антител. Использование базисной иммуносупрессивной терапии такролимусом и микрофенолата мофетилом оказалось наиболее эффективным для профилактики AMR при наименьшем количестве побочных эффектов [9]
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