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首页> 外文期刊>Indian Journal of Pediatrics >Pediatric heart and lung transplantation
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Pediatric heart and lung transplantation

机译：小儿心脏和肺移植

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During the last two decades, several advances have resulted in marked improvement in medium-term survival with excellent quality of life in pediatric heart transplant recipients. These were possible due to better donor and recipient selection, increased surgical experience in transplantation for complex congenital heart disease, development of effective rejection surveillance, and wider choice of immunosuppressive medications. Despite all of these advances, recipients suffer from the adverse effects of non-specific immunosuppression including infections, post-transplant lymphoproliferative disorders and other malignancies, renal dysfunction and other important end-organ toxicities. Furthermore, newer immunosuppressive regimens appear (so far) to have had relatively little impact on the incidence of allograft coronary vasculopathy (chronic rejection). Progress in our understanding of the immunologic mechanisms of rejection and graft acceptance should lead to more targeted immunosuppressive therapy and avoidance of non-specific immunosuppression. The ultimate goal is to induce a state of tolerance, wherein the recipient will accept the allograft indefinitely without the need for long-term immunosuppression and yet remain immunocompetent to other antigens. This quest is currently being realized in many animal models of solid organ transplantation and offers great hope for the future. Key words Allograft - Rejection - Immunosuppression - Post-Transplant coronary vasculopathy
机译：在过去的二十年中，小儿心脏移植受者的一些进步已导致中期生存率显着提高，并具有出色的生活质量。由于更好的供体和受体选择，复杂先天性心脏病移植手术经验的增加，有效排斥监测的发展以及免疫抑制药物的更多选择，这些成为可能。尽管取得了所有这些进步，但受体仍遭受非特异性免疫抑制的不良影响，包括感染，移植后的淋巴增生性疾病和其他恶性肿瘤，肾功能不全和其他重要的终末器官毒性。此外，较新的免疫抑制方案（到目前为止）似乎对同种异体移植冠状动脉疾病（慢性排斥）的发生率影响相对较小。在我们对排斥和移植物接受的免疫学机制的理解上的进展应导致更有针对性的免疫抑制治疗和避免非特异性免疫抑制。最终目的是诱导一种耐受状态，其中接受者将无限期接受同种异体移植而无需长期的免疫抑制，而仍保持对其他抗原的免疫能力。该追求目前正在许多实体器官移植动物模型中实现，并为未来带来了巨大希望。关键词同种异体移植-排斥反应-免疫抑制-移植后冠状动脉病变

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