肾移植术后血栓性微血管病诊治进展OA
Progress in the diagnosis and treatment of thrombotic microangiopathy after kidney transplantation
肾移植术后血栓性微血管病(TMA)是一种罕见但严重的并发症,以微血管病性溶血性贫血、血小板减少及移植物功能障碍为特征,是导致移植物丢失和受者死亡的重要原因.肾移植术后TMA病因复杂,包括钙调磷酸酶抑制剂毒性、抗体介导的排斥反应、感染及药物因素等.近年来,随着对补体系统在肾移植术后TMA中核心作用的深入理解,补体C5抑制剂(如依库珠单抗、雷夫利珠单抗)的应用彻底改变了该病的治疗格局与预后.因此,本文旨在基于近年的最新文献,从病因、诊断、治疗及预后等方面对肾移植术后TMA的诊治进展进行系统综述,以期为肾移植术后TMA的临床管理提供参考.
Thrombotic microangiopathy(TMA)after kidney transplantation is a rare but serious complication characterized by microangiopathic hemolytic anemia,thrombocytopenia and graft dysfunction.It is an important cause of both graft loss and recipient death.The etiology of TMA after kidney transplantation is complex,encompassing calcineurin-inhibitor toxicity,antibody-mediated rejection,infection and drug factors.In recent years,with the in-depth understanding of the core role of the complement system in TMA after kidney transplantation,the application of complement C5 inhibitors(such as eculizumab and ravulizumab)has completely changed the treatment landscape and prognosis of this disease.Therefore,this article aims to provide a systematic review of the progress in the diagnosis and treatment of TMA after kidney transplantation based on the latest literature in recent years,from the aspects of etiology,diagnosis treatment and prognosis,in order to provide a reference for the clinical management of TMA after kidney transplantation.
王晨鸽;李杨
710054 西安,西安交通大学医学院第一附属医院肾移植科710054 西安,西安交通大学医学院第一附属医院肾移植科
医药卫生
肾移植血栓性微血管病补体依库珠单抗雷夫利珠单抗抗体介导的排斥反应感染免疫抑制药
Kidney transplantationThrombotic microangiopathyComplementEculizumabRavulizumabAntibody-mediated rejectionInfectionImmunosuppressant
《器官移植》 2026 (1)
36-43,8
陕西省创新能力支撑计划项目(2025RS-CXTD-054)中国器官移植发展基金会课题
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