Titre
Simultaneous combined transplantation: Intricacies in immunosuppression management.
Type
synthèse (review)
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Del Bello, A.
Auteure/Auteur
Vionnet, J.
Auteure/Auteur
Congy-Jolivet, N.
Auteure/Auteur
Kamar, N.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1557-9816
Statut éditorial
Publié
Date de publication
2024-12
Volume
38
Numéro
4
Première page
100871
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Publication Status: ppublish
Résumé
Simultaneous combined transplantation (SCT), i.e. the transplantation of two solid organs within the same procedure, can be required when the patients develop more than one end-stage organ failure. The development of SCT over the last 20 years could only be possible thanks to progress in the surgical techniques and in the perioperative management of patients in an ageing population. Performing such major transplant surgeries from the same donor, in a short amount of time, and in critical pathophysiological conditions, is often considered to be counterbalanced by the immune benefits expected from these interventions. However, SCT includes a wide array of different transplant combinations, with each time a different immunological constellation. Recent research offers new insights into the immune mechanisms involved in these different settings. Progress in the understanding of these immunological intricacies help to address the optimal induction and maintenance immunosuppressive treatment strategies. In this review, we summarize the different immunological benefits according to the type of SCT performed. We also incorporate the main outcomes according to the immunological risk at transplantation, and the deleterious impact of preformed or de novo donor-specific antibodies (DSA) in the different types of SCT. Finally, we propose comprehensive and evidence-based induction and maintenance immunosuppression strategies guided by the type of SCT.
PID Serval
serval:BIB_ADE0D933916F
PMID
Date de création
2024-08-09T13:15:55.372Z
Date de création dans IRIS
2025-05-21T04:51:07Z