KMID : 0811820080120020133
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Journal of Korean Society of Pediatric Nephrology 2008 Volume.12 No. 2 p.133 ~ p.142
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Allograft Immune Reaction of Kidney Transp lantation Part 2. Immunosuppression and Methods to Assess Alloimmunity
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Kang Hee-Gyung
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Abstract
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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.
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KEYWORD
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Allograft immunity, Anti-HLA antibody, PRA(panel reactive antibody), Crossmatch, Immunosuppressant
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