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Antibody-mediated rejection of the liver allograft: An update and a clinico-pathological perspective
Journal of Hepatology ( IF 25.7 ) Pub Date : 2021-07-31 , DOI: 10.1016/j.jhep.2021.07.027
Brian T Lee 1 , M Isabel Fiel 2 , Thomas D Schiano 3
Affiliation  

Antibody-mediated rejection after liver transplantation is an under-recognised cause of allograft injury. While definitions of acute and chronic antibody-mediated rejection have increased clinical awareness, timely identification and management of antibody-mediated rejection remain difficult because of complexities in diagnosis and histopathology, lack of treatment protocols, and unclear long-term outcomes. While recent cohort studies assessing the importance of donor-specific antibodies have aided in its diagnosis, literature on the treatment of antibody-mediated rejection in liver transplantation remain limited to case reports and small series. Further increasing the awareness and timely recognition of antibody-mediated rejection post-liver transplantation is crucial in order to stimulate future research and the development of protocols for its diagnosis and treatment. This review will summarise recent advances in the clinical diagnosis and treatment of antibody-mediated rejection in liver transplantation, as well as some of the histopathologic features (on liver biopsy tissue) of acute and chronic antibody-mediated rejection.



中文翻译:

抗体介导的同种异体肝排斥反应:更新和临床病理学观点

肝移植后抗体介导的排斥是同种异体移植损伤的一个未被充分认识的原因。虽然急性和慢性抗体介导的排斥反应的定义提高了临床意识,但由于诊断和组织病理学的复杂性、缺乏治疗方案以及长期结果不明确,及时识别和管理抗体介导的排斥反应仍然很困难。虽然最近评估供体特异性抗体重要性的队列研究有助于其诊断,但关于肝移植中抗体介导排斥治疗的文献仍然仅限于病例报告和小型系列研究。进一步提高对肝移植后抗体介导的排斥反应的认识和及时识别对于刺激未来的研究和诊断和治疗方案的开发至关重要。本综述将总结肝移植中抗体介导排斥反应的临床诊断和治疗的最新进展,以及急性和慢性抗体介导排斥反应的一些组织病理学特征(肝活检组织)。

更新日期:2021-07-31
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