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HLA neshody u pacientů po opakované transplantaci ledviny a incidence akutní buněčné a protilátkami zprostředkované rejekce.
Karasová, Alexandra ; Slavčev, Antonij (advisor) ; Ambrůzová, Zuzana (referee)
Kidney transplantation is the most appropriate treatment for end-stage kidney failure. The risk of graft failure in retransplanted patients is generally higher than in first-transplant patients due to immunological and non-immunological reasons. An important risk factor to consider for retransplant patients is their sensitization, i.e. the presence of antibodies directed to HLA antigens of previous donor(s). For that reason, a project called Forbidden (Non-acceptable) Antigens was launched by IKEM with the aim of reducing the incidence of acute cellular and antibody-mediated rejection in retransplant patients. Work on the project was carried out between the years 2011-2013. Forbidden antigens were defined as mismatched HLA antigens of previous kidney donor(s) against which patients waiting for retransplantation produced antibodies. The aim of this diploma thesis is to evaluate whether the incidence of rejection is lower in patients with forbidden HLA antigens in comparison with a control cohort, where no forbidden antigens are defined. 234 patients (162 males and 72 females) were included in the study. Almost all tested patients were producing HLA antibodies (90.2%) and forbidden antigens were determined in 71.4% of patients. In a control group of 267 patients waiting for their first transplantation, the...
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HLA neshody u pacientů po opakované transplantaci ledviny a incidence akutní buněčné a protilátkami zprostředkované rejekce.
Karasová, Alexandra ; Slavčev, Antonij (advisor) ; Ambrůzová, Zuzana (referee)
Kidney transplantation is the most appropriate treatment for end-stage kidney failure. The risk of graft failure in retransplanted patients is generally higher than in first-transplant patients due to immunological and non-immunological reasons. An important risk factor to consider for retransplant patients is their sensitization, i.e. the presence of antibodies directed to HLA antigens of previous donor(s). For that reason, a project called Forbidden (Non-acceptable) Antigens was launched by IKEM with the aim of reducing the incidence of acute cellular and antibody-mediated rejection in retransplant patients. Work on the project was carried out between the years 2011-2013. Forbidden antigens were defined as mismatched HLA antigens of previous kidney donor(s) against which patients waiting for retransplantation produced antibodies. The aim of this diploma thesis is to evaluate whether the incidence of rejection is lower in patients with forbidden HLA antigens in comparison with a control cohort, where no forbidden antigens are defined. 234 patients (162 males and 72 females) were included in the study. Almost all tested patients were producing HLA antibodies (90.2%) and forbidden antigens were determined in 71.4% of patients. In a control group of 267 patients waiting for their first transplantation, the...
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HLA complex and association with autoimmune diseases
Karasová, Alexandra ; Slavčev, Antonij (advisor) ; Šírová, Milada (referee)
Autoimmune diseases are serious and sometimes life-threatening disorders that affect approximately 5 % of the world population and therefore represent a major socio-medical problem. The HLA complex is the best studied part of the human genome that encodes the HLA antigens, whose function is to present peptides to immune system (T-lymphocytes). During the study of the HLA complex it has been found that certain HLA antigens are strongly associated with the occurence of autoimmune diseases, despite the great progress in clarifying disease etiopathogenesis the mechanism of these associations is, however, not fully explained. Sometimes the association of autoimmune disease with the HLA complex is very strong, such as in ankylosing spondylitis or celiac disease, while in other diseases the association is relatively weak, suggesting a role of other genetic and / or environmental factors. The aim of this work is to briefly explain the structure and function of the HLA complex and its association with some severe autoimmune diseases.
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