Emerging phenotypes in kidney transplant rejection.

IF 1.8 4区 医学 Q3 TRANSPLANTATION
Michael Mengel, Benjamin A Adam
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引用次数: 0

Abstract

Purpose of review: This review focuses on more recently emerging rejection phenotypes in the context of time post transplantation and the resulting differential diagnostic challenges. It also discusses how novel ancillary diagnostic tools can potentially increase the accuracy of biopsy-based rejection diagnosis.

Recent findings: With advances in reducing immunological risk at transplantation and improved immunosuppression treatment renal allograft survival improved. However, allograft rejection remains a major challenge and represent a frequent course for allograft failure. With prolonged allograft survival, novel phenotypes of rejection are emerging, which can show complex overlap and transition between cellular and antibody-mediated rejection mechanisms as well as mixtures of acute/active and chronic diseases. With the emerging complexity in rejection phenotypes, it is crucial to achieve diagnostic accuracy in the individual patient.

Summary: The prospective validation and adoption of novel molecular and computational diagnostic tools into well defined and appropriate clinical context of uses will improve our ability to accurately diagnose, stage, and grade allograft rejection.

肾移植排斥反应的新表型。
综述的目的:这篇综述的重点是在移植后的时间背景下最近出现的排斥表型和由此产生的鉴别诊断挑战。它还讨论了新的辅助诊断工具如何潜在地提高基于活检的排斥诊断的准确性。最近发现:随着降低移植免疫风险和改进免疫抑制治疗的进展,移植肾的存活率提高。然而,同种异体移植排斥反应仍然是主要的挑战,也是同种异体移植失败的常见原因。随着同种异体移植存活时间的延长,新的排斥表型正在出现,它们可以在细胞和抗体介导的排斥机制之间以及急性/活动性和慢性疾病的混合物中表现出复杂的重叠和过渡。随着排斥表型的日益复杂,在个体患者中实现诊断准确性至关重要。摘要:前瞻性验证和采用新的分子和计算诊断工具,以明确和适当的临床使用背景,将提高我们准确诊断、分期和分级同种异体移植排斥反应的能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.10
自引率
4.50%
发文量
124
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Current Opinion in Organ Transplantation is an indispensable resource featuring key, up-to-date and important advances in the field from around the world. Led by renowned guest editors for each section, every bimonthly issue of Current Opinion in Organ Transplantation delivers a fresh insight into topics such as stem cell transplantation, immunosuppression, tolerance induction and organ preservation and procurement. With 18 sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, surgeons and other healthcare professionals alike.
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