Mahmut N. ÇARİN, Gonca Emel KARAHAN, Fatma Sevcan OĞUZ

Renal re-transplantasyona hazırlanan hastaların anti-HLA antikor durumları ile ilgili yaklaşımlar

Bu derleme, renal re-transplantasyoha hazırlanan hastalarda anti-HLA antikor gelişim metonizmatarına^daklahmaktadır. Bu antikorların nakil öncesi dönemde var olması veya nakil spnrası de noyo üretj'mteri yıllar içerisinde graft yetmezliği ile sonlanır. Dönore özgü olan,ya da olmayan bu anti-HLA antikorların graft sağkalımı üzerine olan hasarlayıcı etkilerine ek olarak, pek çok çalışmada HLA dışı antikorlar (örn; anti-MICA antikorları), oto-antikorlar, allo-nefrektomi ve karaciğer ve böbreğin birlikte naklinin rejeksiyon süreçlerine etkilerini incelenmiştir.,Bunların yanı sıra, son yıllarda geliştirilen ve 'HLAMatchmaker' olarak adlandırılan bir bilgisayar algoritması, bekleme listelerinde uzun yıllar bekleyen ve nakil olma ihtimalleri çok düşük olan yüksek oranda sensitize bireyler için umut ışığı olma özelliğindedir.

Appoaches to anti-HLA antibody profiles in patients waiting for renal re-transolantation

This review focuses on the mechanisms of anti-HLA antibody, development in patients waiting for a renal re-transplantation. Pre'r existence or post transplant de novo production of these antibodies', have been found to contribute to renal allograft failure in years. In addition to the detrimental effect of donor specific and. nolvdonor. specific artti-HLA antibodies on graft survival, many, researchers emphasized the effect of non-HLA antibodies (e.g.; anti-MICA antibodies); auto-antibodies (e.g.; anti-vimentin antibodies), allo-nephrectömy and combined liver-kidney transplantations on rejection processes. Beyond all these, a newly developed computer algorithm, 'HLAMatchmaker' has changed the concept of transplantation possibility in highly sensitized patients.

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