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Desensitization and management of allograft rejection.

Publication ,  Journal Article
Zaffiri, L
Published in: Curr Opin Organ Transplant
June 1, 2021

PURPOSE OF REVIEW: Chronic lung allograft dysfunction (CLAD) limits the success of lung transplantation. Among the risk factors associated with CLAD, we recognize pretransplant circulating antibodies against the human leukocyte antigens (HLA), acute cellular rejection (ACR) and antibody-mediated rejection (AMR). This review will summarize current data surrounding management of desensitization, ACR, AMR, and CLAD. RECENT FINDINGS: Strategies in managing in highly sensitized patients waiting for lung transplant include avoidance of specific HLA antigens and reduction of circulating anti-HLA antibodies at time of transplant. Several multimodal approaches have been studied in the treatment of AMR with a goal to clear circulating donor-specific antibodies (DSAs) and to halt the production of new antibodies. Different immunosuppressive strategies focus on influence of the host immune system, particularly T-cell responses, in order to prevent ACR and the progression of CLAD. SUMMARY: The lack of significant evidence and consensus limits to draw conclusion regarding the impact of specific immunosuppressive regimens in the management of HLA antibodies, ACR, and CLAD. Development of novel therapeutic agents and use of multicenter randomized clinical trials will allow to better define patient-specific treatments and improve the length and quality of life of lung transplant recipients.

Duke Scholars

Published In

Curr Opin Organ Transplant

DOI

EISSN

1531-7013

Publication Date

June 1, 2021

Volume

26

Issue

3

Start / End Page

314 / 320

Location

United States

Related Subject Headings

  • Surgery
  • Quality of Life
  • Multicenter Studies as Topic
  • Lung Transplantation
  • Isoantibodies
  • Humans
  • HLA Antigens
  • Graft Rejection
  • Allografts
  • 3204 Immunology
 

Citation

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MLA
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Zaffiri, L. (2021). Desensitization and management of allograft rejection. Curr Opin Organ Transplant, 26(3), 314–320. https://doi.org/10.1097/MOT.0000000000000878
Zaffiri, Lorenzo. “Desensitization and management of allograft rejection.Curr Opin Organ Transplant 26, no. 3 (June 1, 2021): 314–20. https://doi.org/10.1097/MOT.0000000000000878.
Zaffiri L. Desensitization and management of allograft rejection. Curr Opin Organ Transplant. 2021 Jun 1;26(3):314–20.
Zaffiri, Lorenzo. “Desensitization and management of allograft rejection.Curr Opin Organ Transplant, vol. 26, no. 3, June 2021, pp. 314–20. Pubmed, doi:10.1097/MOT.0000000000000878.
Zaffiri L. Desensitization and management of allograft rejection. Curr Opin Organ Transplant. 2021 Jun 1;26(3):314–320.

Published In

Curr Opin Organ Transplant

DOI

EISSN

1531-7013

Publication Date

June 1, 2021

Volume

26

Issue

3

Start / End Page

314 / 320

Location

United States

Related Subject Headings

  • Surgery
  • Quality of Life
  • Multicenter Studies as Topic
  • Lung Transplantation
  • Isoantibodies
  • Humans
  • HLA Antigens
  • Graft Rejection
  • Allografts
  • 3204 Immunology