HLA配型对器官移植效果的影响

综述近五年心，肺，肝，肾等实质性器官移植中ＨＬＡ配型的临床意义和争论要点，分析了ＨＬＡ相容性对各种器官移植排以应和存活率的影响。     

循证医学与器官移植

所谓循证医学 (Ｅｖｉｄｅｎｃｅｂａｓｅｄｍｅｄｉｃｉｎｅ ,ＥＢＭ )是指遵循科学依据的医学 ,提倡结合当前最好的临床研究依据、医生的专业知识技能和患者的选择作出临床决定 ,其结果是医生和患者形成诊治联盟 ,患者获得最好的临床疗效和生存质量。循证医学的概念最早见于 1992年ＧａｒｄｏｎＧｕｙａｔｔ等在ＪＡＭＡ上发表的文章 ,1994年随着ＤａｖｉｄＳａｋｋｅｔｔ的专著“Ｈｏｗｔｏｐｒａｃｔｉｃｅａｎｄｔｅａｃｈｅｖｉｄｅｎｃｅｂａｓｅｄｍｅｄｉｃｉｎｅ”问世而得以广为人知。人们在研究中发现 :⑴一些理论上有效的疗法 …     

再论器官移植的实验研究

我在去年本刊的述评中说过：“实验研究是临床医学的先导、基础、依据和保证”，肯定了实验研究在器官移植学科中的重要作用。从本刊选稿中也有同样体会，１９９７年全年刊出论著７６篇，实验研究占一半有余，为３９篇。回顾上次述评内容，意犹未尽，适值重逢本期实验研究...     

重视提高活体器官移植供者安全性的措施

活体器官移植供体手术是施加给一个健康人并对他无任何治疗益处的过程.因此要从术前评估到术中、术后出现的问题进行全面谨慎的考虑.只有在预期受体可获得良好结果时才可进行,并且应将供体的利益放在第一位,将其手术风险降到最低.活体器官移植还涉及医学伦理学、法律、医疗保险以及其他社会问题,需要广泛深入的研究.     

实施器官移植的组织工作与人员培训

早在本世纪初期，人类就开始了器官移植的尝试。１９０５年，Ｐｒｉｎｃｅｔｅａｕ将兔肾的碎片埋藏于病人的肾包膜下，希望藉此促使病人自身肾脏的恢复。这个在今天看来很幼稚的实验拉开了大器官移植研究的序幕。从此，人类在这一领域进行了近一个世纪的艰苦探索，并最终...     

美国器官移植相关系统简介

器官移植是20世纪医学进步的最主要成果之一。回眸历史，现代器官移植是自然科学与社会科学发展的共同成果，更是医学与政治、经济、文化的碰撞与包容，其在涉及医学技术、材料、运输、通讯等硬件的同时，更触及了法律、伦理、教育、信仰等软件内容。它是一项系统工程，科学的系统管理是器官移植成熟与发展的重要标志与保证。环顾世界，各国器官移植的发展并不平衡，技术差距大，管理亦有别。     

第十届全军器官移植学术会议纪要

第十届全军器官移植学术会议于2016年9月24日在北京隆重召开。本次会议由解放军器官移植学专业委员会、《解放军医学杂志》编辑部、中国健康促进基金会共同主办,由解放军第309医院全军器官移植研究所承办。以“军民融合、跨界互联、协同创新”为主题。邀请了军内外肝、肾、肺、儿童移植,护理、转基因动物模型,医学信息技术等领域的专家以及国家卫生和计划生育委员会医政医管局领导进行近30场报告,学术会议视野高远开阔,内容丰富新颖,讨论气氛热烈,大会取得了圆满成功。     

流式细胞分析技术在组织相容性试验中的应用

近年来，流式细胞分析技术在组织相容性试验中的应用受到越来越多HLA实验室的关注。随着很多造血干细胞库和脐带血库的建立，需要高通量的组织相容性实验技术以适应大样本的组织配型工作。本文就近年国外关于流式细胞分析技术在HLA抗原(基因)分型和HLA抗体分析方面的研究进展作一综述。     

Toll样受体信号传导通路及其在器官移植中作用的研究进展

目的了解Toll样受体(TLRs)信号传导通路及其在器官移植中的作用的研究进展。方法通过文献检索并总结TLRs及其配体结构、功能的特点,就近年来TLRs信号传导通路在动物实验和临床器官移植中的作用的研究进展进行综述。结果 TLRs在器官移植中发挥着重要作用,TLRs的活化可激活特异性免疫系统,使移植物发生缺血再灌注损伤、急性排斥反应和慢性排斥反应,同时也可通过TLRs诱导免疫耐受。早期治疗措施的干预可减少器官移植中移植物因缺血再灌注损伤所致的TLRs激活,从而提高移植物存活率;同时,针对TLRs及其介导的信号传导通路的相关免疫抑制靶点研发出的高效免疫抑制药物可减轻器官移植后缺血再灌注损伤和免疫排斥反应。结论 TLRs信号传导通路在缺血再灌注损伤、免疫排斥及免疫调节中起着重要作用。     

Infection in Organ Transplantation

The prevention, diagnosis, and management of infectious disease in transplantation are major contributors to improved outcomes in organ transplantation. The risk of serious infections in organ recipients is determined by interactions between the patient's epidemiological exposures and net state of immune suppression. In organ recipients, there is a significant incidence of drug toxicity and a propensity for drug interactions with immunosuppressive agents used to maintain graft function. Thus, every effort must be made to establish specific microbiologic diagnoses to optimize therapy. A timeline can be created to develop a differential diagnosis of infection in transplantation based on common patterns of infectious exposures, immunosuppressive management, and antimicrobial prophylaxis. Application of quantitative molecular microbial assays and advanced antimicrobial therapies have advanced care. Pathogen‐specific immunity, genetic polymorphisms in immune responses, and dynamic interactions between the microbiome and the risk of infection are beginning to be explored. The role of infection in the stimulation of alloimmune responses awaits further definition. Major hurdles include the shifting worldwide epidemiology of infections, increasing antimicrobial resistance, suboptimal assays for the microbiologic screening of organ donors, and virus‐associated malignancies. Transplant infectious disease remains a key to the clinical and scientific investigation of organ transplantation.     

Attitudes Toward Organ Transplantation

BackgroundThe purpose of transplantation is to improve the health or save the life of the recipient. Although organ transplantation is a method generally accepted by society, there are still people who, referring to moral and ethical aspects, reject its validity. A great threat to transplantology is also the lack of knowledge of the society resulting from insufficient education.AimThe aim of this study was to find out attitudes and opinions about organ transplantation and to determine the level of acceptance of organ and tissue transplantation.MethodsThe tool chosen for the study was a survey questionnaire. The research group consisted of 200 people. Approval from the Bioethics Committee was obtained to conduct the study.ResultsThe studies showed that more than half of the respondents (57%) would agree to organ donation for transplantation after the death of a loved one. Age was found to be statistically significant (P = .001). Older people showed more doubts about transplantation than people under 30. Over 80% of respondents agreed that initiatives to educate the public about transplantation are needed.ConclusionsThe respondents refer to transplantation positively as a method of treating and saving life, and more than half of respondents would agree to donate their organs for transplant after the death of a loved one. The majority of respondents described their attitude toward transplantation as positive, admitting that the objection to donating is due to the ignorance and too little awareness on the subject.