Siv cov enzymes tsim nyog, cov kws tshawb fawb tshem tawm ABO cov ntshav pab pawg antigens los ntawm cov neeg pub lub raum thiab lub ntsws ex-vivo, kom kov yeej ABO cov ntshav tsis sib haum. Txoj hauv kev no tuaj yeem daws qhov tsis txaus ntawm lub cev los ntawm kev txhim kho qhov muaj cov khoom nruab nrog cev rau kev hloov pauv ntau thiab ua kom cov txheej txheem ntawm kev faib khoom nruab nrog cev ncaj ncees thiab ua haujlwm tau zoo dua.
Hauv kev tshawb fawb tsis ntev los no, cov kws tshawb fawb tau siv alpha-galactosidase enzyme los ntawm Bacteroides fragilis thiab ntse tshem tawm hom B ntshav pawg antigens los ntawm tib neeg raum (uas tseem tsis tau siv rau kev hloov pauv) thaum lub sijhawm ex-vivo perfusion yog li hloov cov ntshav ntawm lub raum mus rau universal pub O. Qhov no yog thawj kis ntawm tag nrho cov kabmob ABO. ntshav Kev hloov pauv pawg hauv tib neeg los ntawm kev tshem tawm enzymatic ntawm hom B ntshav pawg antigens1.
Hauv lwm qhov kev tshawb fawb zoo sib xws ntawm lub ntsws, cov kws tshawb fawb tau hloov dua siab tshiab ntshav pawg A lub ntsws rau ntshav pab pawg O lub ntsws thaum ex-vivo ntsws perfusion siv ob lub enzymes, FpGalNAc deacetylase thiab FpGalactosaminidase. Tsis muaj kev hloov pauv tseem ceeb hauv kev noj qab haus huv ntawm lub ntsws nrog rau cov tshuaj tiv thaiv kab mob sib kis tau raug soj ntsuam2,3.
cia li zoo li ntshav Kev hloov ntshav, ABO cov ntshav sib txuam yog qhov tseem ceeb hauv kev faib cov khoom nruab nrog cev ntawm cov neeg tau txais yav tom ntej. Kev muaj cov A thiab/lossis B antigens hauv cov khoom pub dawb ua rau kev xaiv xaiv thiab txwv. Raws li qhov tshwm sim, kev faib tawm tsis muaj txiaj ntsig. Muaj peev xwm hloov ABO ntshav pab pawg ntawm cov khoom nruab nrog cev ex-vivo rau universal pub dawb los ntawm kev tshem tawm A thiab/lossis B antigens yuav nthuav dav lub pas dej ua ke ntawm ABO tshaj tus neeg pub khoom nruab nrog los daws qhov teeb meem ntawm lub cev tsis txaus thiab txhim kho kev ncaj ncees hauv kev faib khoom nruab nrog cev rau hloov pauv.
Ntau txoj hauv kev (xws li kev tshem tawm cov tshuaj tiv thaiv kab mob, splenectomy, anti-CD20 monoclonal antibody, thiab cov tshuaj tiv thaiv kab mob hauv lub cev) tau raug sim yav dhau los los txhim kho kev vam meej ntawm kev hloov pauv tiam sis ABO incompatibility tseem muaj teeb meem. Cov lus pom zoo kom tshem tawm A / B antigens los ntawm 2007 thaum cov kws tshawb fawb tau txo qis A / B antigens hauv baboon siv ABase enzyme.4. Tsis ntev tom qab ntawd, lawv muaj peev xwm tshem tawm 82% ntawm A antigen thiab 95% ntawm B antigen hauv tib neeg A/B liab ntshav Cell siv ABase5.
Txoj hauv kev ntawm enzymatic A / B antigen tshem tawm los ntawm cov neeg pub khoom nruab nrog cev tau tuaj txog hnub nyoog rau kev hloov hauv lub raum thiab lub ntsws. Txawm li cas los xij, tsis muaj pov thawj me me hauv cov ntaub ntawv ntawm kev siv tau ntawm txoj hauv kev no rau kev hloov lub siab. Es tsis txhob, desensitisation6,7 nrog tshuaj tiv thaiv zoo li tau tuav cov lus cog tseg rau kev txhim kho kev vam meej nrog rau lub pas dej ntawm daim siab hloov pauv.
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References:
- S MacMillan, SA Hosgood, ML Nicholson, O004 ntshav pab pawg antigen tshem tawm ntawm tib neeg lub raum siv ex-vivo normothermic tshuab perfusion technology, British Journal of Surgery, Volume 109, Issue Supplement_4, August 2022, znac242.004, https://doi.org/10.1093/bjs/znac242.004 | https://academic.oup.com/bjs/article/109/Supplement_4/znac242.004/6648600
- Wang A., thiab al 2021. Tsim Universal ABO Ntshav Hom Pub Lungs nrog Ex Vivo Enzymatic Treatment: Ib Daim Ntawv Pov Thawj ntawm Lub Tswv Yim Feasibility Stud. Phau ntawv Journal of Heart and Lung Transplantation. Volume 40, Issue 4, Supplement, s15-s16, April 01, 2021. DOI: https://doi.org/10.1016/j.healun.2021.01.1773
- Wang A., thiab al 2022. Ex vivo enzymatic kev kho mob hloov cov ntshav hom A pub rau lub ntsws mus rau hauv lub ntsws universal. Science Translational Tshuaj. 16 Feb 2022. Vol 14, Issue 632. DOI: https://doi.org/10.1126/scitranslmed.abm7190
- Kev, T., thiab al 2007. Lwm Lub Tswv Yim rau Kev Tshaj Tawm ABO Incompatibility. Kev hloov pauv: Tsib Hlis 15, 2007 - Ntu 83 - Nqe 9 - p 1284-1286. DOI: https://doi.org/10.1097/01.tp.0000260634.85690.c4
- Kobayashi T. thiab al 2009. Kev tshem tawm cov ntshav pab pawg A/B antigen hauv lub cev los ntawm ex vivo thiab hauv vivo tswj hwm endo-ß-galactosidase (ABase) rau ABO-incompatible transplantation. Hloov Immunology. Nqe 20, Nqe 3, Lub Ib Hlis 2009, Nplooj 132-138. DOI: https://doi.org/10.1016/j.trim.2008.09.007
- Dogar AW thiab al 2022. ABO incompatible nyob pub lub siab hloov nrog cov tshuaj tiv thaiv titer ntawm 1: 4: Thawj rooj plaub qhia los ntawm Pakistan. Annals of Medicine and Surgery Volume 81, September 2022, 104463. DOI: https://doi.org/10.1016/j.amsu.2022.104463
- Akamatsu N., thiab al 2021. Rituximab Desensitization nyob rau hauv daim siab Transplant Recipients With Preformed Donor-specific HLA Antibodies: A Japanese Nationwide Survey. Hloov Direct. Aug 2021; 7 (8): e729. Published online 2021 Jul 16. DOI: https://doi.org/10.1097/TXD.0000000000001180
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