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13.
Aloreaktivnost in alosenzibilizacija pri bolnikih s presajenimi tkivi in organi = Alloreactivity and allosensibilization in patients with transplanted tissues and organs
Jeras, Matjaž
Transplantation of organs and tissues from related as well as unrelated, living and cadaveric donors used for the replacement of diseased or a damaged ones in patients is an important segment of ...today's clinical therapies. One ofthe key factors influencing the success of transplantation is the intensivity of the alloimune response to transplanted tissue. It is shaped by the degree of histocompatibility between the donor and recipient of the transplant as well as the episodes of prior allosensibilisations of the patient, due to multiple blood transfusions, rejected transplants or pregnancies. Whenever a transplanted tissue contains nucleated cells, a substantial alloimmune response of donor's (bone marrow) or recipient's lymphocytes T is to be expected, recognising foreign MHC molecules, which are extremely polymorphic. A complete identity considering tissue antigens as wellas other polymorphic genetic markers which can also influence the success of the transplantation is limited to closerly related persons. Several tools are used to assess the degree of histocompatibility between the donors and recipients of transplants: the typing of HLA molecules and/or alleles accompanied by several in vitro functional tests, like one-way mixed lymphocyte reactions and the estimations of frequencies of cytotoxic and helper T cell presursors. Additional extensive screening tests are performed for the patients included in waiting lists for organ transplantation reviling the potential existence and specificity of anti-HLA antibodies.
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