Allograft Immune Reaction of Kidney Transplantation Part 2. Immunosuppression and Methods to Assess Alloimmunity.
- Author:
Hee Gyung KANG
1
Author Information
1. Department of Pediatrics, Seoul National University Childrens Hospital, Korea. kanghg@snu.ac.kr
- Publication Type:Review
- Keywords:
Allograft immunity;
Anti-HLA antibody;
PRA(panel reactive antibody);
Crossmatch;
Immunosuppressant
- MeSH:
Antilymphocyte Serum;
Azathioprine;
Calcineurin;
Graft Survival;
Histocompatibility Testing;
Humans;
Immunosuppression;
Kidney;
Kidney Transplantation;
Tissue Donors;
Transplantation, Homologous;
Transplants
- From:Journal of the Korean Society of Pediatric Nephrology
2008;12(2):133-142
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
For solid organ transplant, ABO blood type of donor and recipient should be compatible in principle. Recent improvement of immunosuppressant made HLA typing not so important while no-mismatch transplant still shows the longest graft survival. PRA(panel reactive antibody) test is to screen and identify recipients with HLA sensitization. When solid organ transplant is scheduled, cross-match test of donor cell and recipient serum should be performed and positive result of cross-match prohibits transplantation. Donor specific antibody (DSA) test can predict the severity of recipient immune reaction against donor organ. Today's mainstay of allograft immunosuppressant regimen is triple therapy of steroid, calcineurin inhibitor(cyclosporine, tacrolimus), azathioprine or mycophenolate mofetil(MMF). Antibody induction using Thymoglobulin or anti-IL-2 receptor antibody(basiliximab or daclizumab) is frequently practiced as well.
