Solid Organ Nakli İmmünolojisi
Özet
Solid organ nakli (transplantasyon); yeterli fonksiyon görmeyen bir organın/dokunun yerine yeni ve sağlıklı bir organ/doku konulması olarak tanımlanabilir. Transplantasyon; tedavi olarak uygulamaya girişi özellikle son 50-70 yılda gerçekleşmiştir. Bu gelişmede, özellikle immünoloji alanında elde edilen yeni bilgiler başarılı trasplantasyon uygulamalarında belirleyici olmuştur. Buna karşın halen transplantasyon konusunda yaşanan en büyük sorun immünolojik olaylar sonucu organ/doku reddi olmaya devam etmektedir. Bu sorunun çözümünde transplantasyon öncesinde yapılan testler ve transplantasyon sonrası uygulanan immünsupresif tedavi en önemli süreç olmaya devam etmektedir. Bu süreçlerde hemşireler, hasta ile en yoğun ilişki kuran sağlık çalışanları olarak çok önemli bir işleve sahiptirler.
Referanslar
Abbas AK, Lıchtman AH, Pıllaı S. Cellular and molecular immunology. Philadelphia: Elsevier; 2018
Starzl TE. History of clinical transplantation. World J Surg. 2000;24(7):759-82. doi: 10.1007/s002680010124
Rowiński W. Future of transplantation medicine. Ann Transplant. 2007;12(1):5-10.
Andre M, Huang E, Everly M, Bunnapradist S. The UNOS Renal Transplant Registry: Review of the Last Decade. Clin Transpl. 2014:1-12
So M, Hand J, Forrest G, et al. White paper on antimicrobial stewardship in solid organ transplant recipients. Am J Transplant. 2022 ;22(1):96-112. doi: 10.1111/ajt.16743.
Yılmaz E. Böbrek nakli öncesi i¬mmünolojik testler. Seyahi N, Trabulus S (eds.) Renal Transplantasyon. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.21-5.
Zwang NA, Turka LA. Transplantation immunology in 2013: New approaches to diagnosis of rejection. Nat Rev Nephrol. 2014 ;10(2):72-4. doi: 10.1038/nrneph.2013.262.
Andrade CF, Waddell TK, Keshavjee S, Liu M. Innate immunity and organ transplantation: the potential role of toll-like receptors. Am J Transplant. 2005 May;5(5):969-75. doi: 10.1111/j.1600- 6143.2005.00829.x
Neefjes, J., Jongsma, M., Paul, P. et al. Towards a systems understanding of MHC class I and MHC class II antigen presentation. Nat Rev Immunol 2011; 11, 823–836. https://doi.org/10.1038/nri3084.
Nakamura T, Shirouzu T, Nakata K, Yoshimura N, Ushigome H. The Role of Major Histocompatibility Complex in Organ Transplantation- Donor Specific Anti-Major Histocompatibility Complex Antibodies Analysis Goes to the Next Stage. Int J Mol Sci. 2019 13;20(18):4544. doi: 10.3390/ijms20184544.
Horton R, Gibson R, Coggill P, Miretti M, Allcock RJ, Almeida J, Forbes S, Gilbert JG, Halls K, Harrow JL, Hart E, Howe K, Jackson DK, Palmer S, Roberts AN, Sims S, Stewart CA, Traherne JA, Trevanion S, Wilming L, Rogers J, de Jong PJ, Elliott JF, Sawcer S, Todd JA, Trowsdale J, Beck S. Variation analysis and gene annotation of eight MHC haplotypes: the MHC Haplotype Project. Immunogenetics. 2008 ;60(1):1-18. doi: 10.1007/s00251-007-0262-2.
Natarajan K, Li H, Mariuzza RA, Margulies DH. MHC class I molecules, structure and function. Rev Immunogenet. 1999;1(1):32-46.
Sadegh-Nasseri S, Kim A. Exogenous antigens bind MHC class II first, and are processed by cathepsins later. Mol Immunol. 2015 ;68(2 Pt A):81-4. doi: 10.1016/j.molimm.2015.07.018.
Kreisel D, Krupnick AS, Gelman AE, Engels FH, Popma SH, Krasinskas AM, Balsara KR, Szeto WY, Turka LA, Rosengard BR. Non-hematopoietic allograft cells directly activate CD8+ T cells and trigger acute rejection: an alternative mechanism of allorecognition. Nat Med. 2002;8(3):233-9. doi: 10.1038/nm0302-233.
Sánchez-Fueyo A, Domenig CM, Mariat C, Alexopoulos S, Zheng XX, Strom TB. Influence of direct and indirect allorecognition pathways on CD4+CD25+ regulatory T-cell function in transplantation. Transpl Int. 2007;20(6):534-41. doi: 10.1111/j.1432-2277.2007.00470.x.
Ford ML. T Cell Cosignaling Molecules in Transplantation. Immunity. 2016 ;44(5):1020-33. doi: 10.1016/j.immuni.2016.04.012.
Li J, Li C, Zhuang Q, Peng B, Zhu Y, Ye Q, Ming Y. The Evolving Roles of Macrophages in Organ Transplantation. J Immunol Res. 2019 ;2019:5763430. doi: 10.1155/2019/5763430.
Amore A. Antibody-mediated rejection. Curr Opin Organ Transplant. 2015 ;20(5):536-42. doi: 10.1097/MOT.0000000000000230.
Dierselhuis M, Goulmy E. The relevance of minor histocompatibility antigens in solid organ transplantation. Curr Opin Organ Transplant. 2009;14(4):419-25. doi: 10.1097/MOT.0b013e32832d399c.
Zorn E, See SB. Antibody Responses to Minor Histocompatibility Antigens After Solid Organ Transplantation. Transplantation. 2022 ;106(4):749-753. doi: 10.1097/TP.0000000000003969.
Etxebarria A, Díez-Martín E, Astigarraga E, Barreda-Gómez G. Role of the Immune System in Renal Transplantation, Types of Response, Technical Approaches and Current Challenges. Immuno 2022;548–570 .doi:10.3390/immuno2040035
Erdoğmuş Ş, Şengül Ş. Immunologic Risk Assessment before Kidney Transplantation: An Update. Turk J Nephrol 2019; 28(3): 216-24.
Montgomery RA, Loupy A, Segev DL. Antibody-mediated rejection: New approaches in prevention and management. Am J Transplant. 2018 ;18 Suppl 3:3-17. doi: 10.1111/ajt.14584.
Mahdi BM. A glow of HLA typing in organ transplantation. Clin Transl Med. 2013;2(1):6. doi: 10.1186/2001-1326-2-6.
Akıncı S, Akıncı N. Organ naklinde immünolojik uygulamalar. In:Özbaş A, (ed.) Organ Nakilleri ve Hemşirelik Bakımı. 1. Baskı. Ankara:Türkiye Klinikleri; 2021. p.17-23.
Mamode N, Bestard O, Claas F, Furian L, Griffin S, Legendre C, Pengel L, Naesens M. European Guideline for the Management of Kidney Transplant Patients With HLA Antibodies: By the European Society for Organ Transplantation Working Group. Transpl Int. 2022 ;35:10511. doi: 10.3389/ti.2022.10511
Choi J, Chandraker A. Immunologic Risk Assessment and Approach to Immunosuppression Regimen in Kidney Transplantation. Clin Lab Med. 2019;39(4):643-656. doi: 10.1016/j.cll.2019.07.010.
Pratschke J, Dragun D, Hauser IA, Horn S, Mueller TF, Schemmer P, Thaiss F. Immunological risk assessment: The key to individualized immunosuppression after kidney transplantation. Transplant Rev (Orlando). 2016 ;30(2):77-84. doi: 10.1016/j.trre.2016.02.002.
Allison TL. Immunosuppressive Therapy in Transplantation. Nurs Clin North Am. 2016 Mar;51(1):107-20. doi: 10.1016/j.cnur.2015.10.008.Hertl M. Transplantation. In. Porter RS (ed.) The Merck Manual of Diagnosis and Therapy. 20th eds, NJ: Merck Sharp &Dohme Corp; 2018. p.1407-
Hertl M. Transplantation. In. Porter RS (ed.) The Merck Manual of Diagnosis and Therapy. 20th eds, NJ: Merck Sharp &Dohme Corp; 2018. p.1407-
Segoloni GP, Quaglia M. New immunosuppressive drugs for prevention and treatment of rejection in renal transplant. J Nephrol. 2006 Sep-Oct;19(5):578-86.
Lai X, Zheng X, Mathew JM, Gallon L, Leventhal JR, Zhang ZJ. Tackling Chronic Kidney Transpant Rejection: Challenges and Promises. Front Immunol. 2021;12:661643. doi: 10.3389/fimmu.2021.661643.
Ünver S, Yıldız Fındık Ü. Organ naklinde immünsupresif tedavi ve bakım. In:Özbaş A (ed.) Organ Nakilleri ve Hemşirelik Bakımı. 1.Baskı. Ankara: Türkiye Klinikleri; 2021. p.24-
Cajanding R. Immunosuppression following organ transplantation. Part 1: mechanisms and immunosuppressive agents. Br J Nurs. 2018 ;27(16):920-927. doi: 10.1298/bjon.2018.27.16.920.
Cajanding R. Immunosuppression following organ transplantation. Part 2: complications and their management. Br J Nurs. 2018 ;27(18):1059-1065. doi: 10.12968/bjon.2018.27.18.1059.
Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005 ;353(5):487-97. doi: 10.1056/NEJMra050100.
Kuypers DRJ. From Nonadherence to Adherence. Transplantation. 2020 ;104(7):1330-1340. doi: 10.1097/TP.0000000000003112.
Frank-Bader M, Beltran K, Dojlidko D. Improving transplant discharge education using a structured teaching approach. Prog Transplant. 2011;21(4):332-9. doi: 10.1177/152692481102100413.
Referanslar
Abbas AK, Lıchtman AH, Pıllaı S. Cellular and molecular immunology. Philadelphia: Elsevier; 2018
Starzl TE. History of clinical transplantation. World J Surg. 2000;24(7):759-82. doi: 10.1007/s002680010124
Rowiński W. Future of transplantation medicine. Ann Transplant. 2007;12(1):5-10.
Andre M, Huang E, Everly M, Bunnapradist S. The UNOS Renal Transplant Registry: Review of the Last Decade. Clin Transpl. 2014:1-12
So M, Hand J, Forrest G, et al. White paper on antimicrobial stewardship in solid organ transplant recipients. Am J Transplant. 2022 ;22(1):96-112. doi: 10.1111/ajt.16743.
Yılmaz E. Böbrek nakli öncesi i¬mmünolojik testler. Seyahi N, Trabulus S (eds.) Renal Transplantasyon. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.21-5.
Zwang NA, Turka LA. Transplantation immunology in 2013: New approaches to diagnosis of rejection. Nat Rev Nephrol. 2014 ;10(2):72-4. doi: 10.1038/nrneph.2013.262.
Andrade CF, Waddell TK, Keshavjee S, Liu M. Innate immunity and organ transplantation: the potential role of toll-like receptors. Am J Transplant. 2005 May;5(5):969-75. doi: 10.1111/j.1600- 6143.2005.00829.x
Neefjes, J., Jongsma, M., Paul, P. et al. Towards a systems understanding of MHC class I and MHC class II antigen presentation. Nat Rev Immunol 2011; 11, 823–836. https://doi.org/10.1038/nri3084.
Nakamura T, Shirouzu T, Nakata K, Yoshimura N, Ushigome H. The Role of Major Histocompatibility Complex in Organ Transplantation- Donor Specific Anti-Major Histocompatibility Complex Antibodies Analysis Goes to the Next Stage. Int J Mol Sci. 2019 13;20(18):4544. doi: 10.3390/ijms20184544.
Horton R, Gibson R, Coggill P, Miretti M, Allcock RJ, Almeida J, Forbes S, Gilbert JG, Halls K, Harrow JL, Hart E, Howe K, Jackson DK, Palmer S, Roberts AN, Sims S, Stewart CA, Traherne JA, Trevanion S, Wilming L, Rogers J, de Jong PJ, Elliott JF, Sawcer S, Todd JA, Trowsdale J, Beck S. Variation analysis and gene annotation of eight MHC haplotypes: the MHC Haplotype Project. Immunogenetics. 2008 ;60(1):1-18. doi: 10.1007/s00251-007-0262-2.
Natarajan K, Li H, Mariuzza RA, Margulies DH. MHC class I molecules, structure and function. Rev Immunogenet. 1999;1(1):32-46.
Sadegh-Nasseri S, Kim A. Exogenous antigens bind MHC class II first, and are processed by cathepsins later. Mol Immunol. 2015 ;68(2 Pt A):81-4. doi: 10.1016/j.molimm.2015.07.018.
Kreisel D, Krupnick AS, Gelman AE, Engels FH, Popma SH, Krasinskas AM, Balsara KR, Szeto WY, Turka LA, Rosengard BR. Non-hematopoietic allograft cells directly activate CD8+ T cells and trigger acute rejection: an alternative mechanism of allorecognition. Nat Med. 2002;8(3):233-9. doi: 10.1038/nm0302-233.
Sánchez-Fueyo A, Domenig CM, Mariat C, Alexopoulos S, Zheng XX, Strom TB. Influence of direct and indirect allorecognition pathways on CD4+CD25+ regulatory T-cell function in transplantation. Transpl Int. 2007;20(6):534-41. doi: 10.1111/j.1432-2277.2007.00470.x.
Ford ML. T Cell Cosignaling Molecules in Transplantation. Immunity. 2016 ;44(5):1020-33. doi: 10.1016/j.immuni.2016.04.012.
Li J, Li C, Zhuang Q, Peng B, Zhu Y, Ye Q, Ming Y. The Evolving Roles of Macrophages in Organ Transplantation. J Immunol Res. 2019 ;2019:5763430. doi: 10.1155/2019/5763430.
Amore A. Antibody-mediated rejection. Curr Opin Organ Transplant. 2015 ;20(5):536-42. doi: 10.1097/MOT.0000000000000230.
Dierselhuis M, Goulmy E. The relevance of minor histocompatibility antigens in solid organ transplantation. Curr Opin Organ Transplant. 2009;14(4):419-25. doi: 10.1097/MOT.0b013e32832d399c.
Zorn E, See SB. Antibody Responses to Minor Histocompatibility Antigens After Solid Organ Transplantation. Transplantation. 2022 ;106(4):749-753. doi: 10.1097/TP.0000000000003969.
Etxebarria A, Díez-Martín E, Astigarraga E, Barreda-Gómez G. Role of the Immune System in Renal Transplantation, Types of Response, Technical Approaches and Current Challenges. Immuno 2022;548–570 .doi:10.3390/immuno2040035
Erdoğmuş Ş, Şengül Ş. Immunologic Risk Assessment before Kidney Transplantation: An Update. Turk J Nephrol 2019; 28(3): 216-24.
Montgomery RA, Loupy A, Segev DL. Antibody-mediated rejection: New approaches in prevention and management. Am J Transplant. 2018 ;18 Suppl 3:3-17. doi: 10.1111/ajt.14584.
Mahdi BM. A glow of HLA typing in organ transplantation. Clin Transl Med. 2013;2(1):6. doi: 10.1186/2001-1326-2-6.
Akıncı S, Akıncı N. Organ naklinde immünolojik uygulamalar. In:Özbaş A, (ed.) Organ Nakilleri ve Hemşirelik Bakımı. 1. Baskı. Ankara:Türkiye Klinikleri; 2021. p.17-23.
Mamode N, Bestard O, Claas F, Furian L, Griffin S, Legendre C, Pengel L, Naesens M. European Guideline for the Management of Kidney Transplant Patients With HLA Antibodies: By the European Society for Organ Transplantation Working Group. Transpl Int. 2022 ;35:10511. doi: 10.3389/ti.2022.10511
Choi J, Chandraker A. Immunologic Risk Assessment and Approach to Immunosuppression Regimen in Kidney Transplantation. Clin Lab Med. 2019;39(4):643-656. doi: 10.1016/j.cll.2019.07.010.
Pratschke J, Dragun D, Hauser IA, Horn S, Mueller TF, Schemmer P, Thaiss F. Immunological risk assessment: The key to individualized immunosuppression after kidney transplantation. Transplant Rev (Orlando). 2016 ;30(2):77-84. doi: 10.1016/j.trre.2016.02.002.
Allison TL. Immunosuppressive Therapy in Transplantation. Nurs Clin North Am. 2016 Mar;51(1):107-20. doi: 10.1016/j.cnur.2015.10.008.Hertl M. Transplantation. In. Porter RS (ed.) The Merck Manual of Diagnosis and Therapy. 20th eds, NJ: Merck Sharp &Dohme Corp; 2018. p.1407-
Hertl M. Transplantation. In. Porter RS (ed.) The Merck Manual of Diagnosis and Therapy. 20th eds, NJ: Merck Sharp &Dohme Corp; 2018. p.1407-
Segoloni GP, Quaglia M. New immunosuppressive drugs for prevention and treatment of rejection in renal transplant. J Nephrol. 2006 Sep-Oct;19(5):578-86.
Lai X, Zheng X, Mathew JM, Gallon L, Leventhal JR, Zhang ZJ. Tackling Chronic Kidney Transpant Rejection: Challenges and Promises. Front Immunol. 2021;12:661643. doi: 10.3389/fimmu.2021.661643.
Ünver S, Yıldız Fındık Ü. Organ naklinde immünsupresif tedavi ve bakım. In:Özbaş A (ed.) Organ Nakilleri ve Hemşirelik Bakımı. 1.Baskı. Ankara: Türkiye Klinikleri; 2021. p.24-
Cajanding R. Immunosuppression following organ transplantation. Part 1: mechanisms and immunosuppressive agents. Br J Nurs. 2018 ;27(16):920-927. doi: 10.1298/bjon.2018.27.16.920.
Cajanding R. Immunosuppression following organ transplantation. Part 2: complications and their management. Br J Nurs. 2018 ;27(18):1059-1065. doi: 10.12968/bjon.2018.27.18.1059.
Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005 ;353(5):487-97. doi: 10.1056/NEJMra050100.
Kuypers DRJ. From Nonadherence to Adherence. Transplantation. 2020 ;104(7):1330-1340. doi: 10.1097/TP.0000000000003112.
Frank-Bader M, Beltran K, Dojlidko D. Improving transplant discharge education using a structured teaching approach. Prog Transplant. 2011;21(4):332-9. doi: 10.1177/152692481102100413.
