Allograft Immune Reaction of Kidney Transp lantation Part 2. Immunosuppression and Methods to Assess Alloimmunity

Kang, Hee-Gyung

doi:2008.12.2.133

J Korean Soc Pediatr Nephrol > Volume 12(2); 2008 > Article

J Korean Soc Pediatr Nephrol 2008;12(2): 133-142. doi: https://doi.org/10.3339/jkspn.2008.12.2.133

신이식 후 면역반응의 이해 2부 이식면역검사와 면역억제제

강희경

서울대학교 어린이병원 소아청소년과

Allograft Immune Reaction of Kidney Transp lantation Part 2. Immunosuppression and Methods to Assess Alloimmunity

Hee-Gyung Kang

Department of Pediatrics, Seoul National University Childrens Hospital

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.

Key words: Allograft immunity | Anti-HLA antibody | PRA(panel reactive antibody) | Crossmatch | Immunosuppressant