O XENOTRANSPLANTE COMO POSSIBILIDADE DE MITIGAR A FILA DE ESPERA PARA TRANSPLANTE DE ÓRGÃOS SÓLIDOS: UMA REVISÃO LITERÁRIA

Autores

  • Isabela Franco Freire
  • Beatriz Valadares Russo
  • Marcela Pinheiro de Alencar Vilar
  • Alexandre Saboia Augusto Borges Filho
  • Silvia Fernandes Ribeiro da Silva

DOI:

https://doi.org/10.51161/rems/2970

Palavras-chave:

HISTOCOMPATIBILIDADE, REJEIÇÃO, XENOTRANSPLANTE

Resumo

Introdução: Transplante é um tratamento eficaz para a falência de órgãos em estágio terminal. No entanto, o desequilíbrio entre o fornecimento e a demanda de órgãos humanos é um empecilho para o transplante clínico. A baixa disponibilidade de órgãos aumenta a mortalidade de pacientes em lista de espera para realização de transplantes de coração e fígado. A realização do transplante interespécie ou xenotransplante configura uma solução promissora para a discrepância atual entre número de doadores e transplantes realizados no Brasil e no Mundo. Entretanto, sabe-se que as barreiras éticas e, principalmente, imunológicas têm limitado a realização do xenotransplante. Objetivos: Compreender os mecanismos utilizados para minimizar riscos de rejeição no xenotransplante e viabilizar a sua realização. Material e Métodos: A revisão foi embasada em pesquisa nas bases de dados PubMed e BVS, utilizando Xenotransplante, Transplante e Rejeição como descritores. Incluiu-se um artigo de 2002 e seis de 2019 a 2021. Resultados: No Brasil, no primeiro semestre de 2021, foram realizados 3.195 alotransplantes. Porém, 45.664 mil pessoas ainda se encontram em lista de espera. Nos alotransplantes, a compatibilidade do Sistema HLA (human leukocyte antigen) entre receptor/doador associado à imunossupressão tem viabilizado os transplantes. Porém, no xenotransplante, a análise da compatibilidade HLA torna-se inviável por não compartilharem, homem e porco, o mesmo sistema de histocompatibilidade, evidenciado pelo fato de anticorpos anti-HLA do homem não reagirem com antígenos de histocompatibilidade do porco. Porém, o homem apresenta anticorpos IgG contra o glicano alfaGal do porco, inviabilizando a realização do xenotransplante devido à rejeição hiperaguda. Porcos transgênicos, em que houve a deleção de alfaGal, possuem órgãos sem esses antígenos alvos de rejeição, não sendo reconhecidos por anticorpos anti-alfaGal do homem. O estudo de hCRPs (proteínas reguladoras de complemento) tem inibido respostas inflamatórias e lesivas mediadas por complemento, aumentando o tempo de vida do enxerto. Além disso, a inserção de genes que regulam negativamente a expressão de antígenos de classe II tem sido um forte aliado no xenotransplante. Conclusão: Xenotransplantes ainda apresentam obstáculos imunológicos que vêm sendo superados, tornando-os alternativas viáveis e a possibilidade de se reduzir filas de espera para transplante.

Publicado

2021-12-21

Como Citar

Freire, I. F. ., Russo, B. V. ., Vilar, M. P. de A. ., Filho, A. S. A. B. ., & Silva, S. F. R. da . (2021). O XENOTRANSPLANTE COMO POSSIBILIDADE DE MITIGAR A FILA DE ESPERA PARA TRANSPLANTE DE ÓRGÃOS SÓLIDOS: UMA REVISÃO LITERÁRIA. Revista Multidisciplinar Em Saúde, 2(4), 204. https://doi.org/10.51161/rems/2970

Edição

Seção

I Congresso Brasileiro de Saúde Pública On-line: Uma abordagem Multiprofissional
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Dispatcher.dispatch(Object:Request) % line  281, file: PKPApplication.inc.php
PKPApplication.execute() % line   68, file: index.php

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                                                      SubmissionSearch._getMergedKeywordResults(Object:Journal, Array[4], , null, null, 500, 1) % line  194, file: SubmissionSearch.inc.php
                                                   SubmissionSearch._getMergedPhraseResults(Object:Journal, Array[4], null, null, null, 500, 1) % line  146, file: SubmissionSearch.inc.php
                                                SubmissionSearch._getMergedKeywordResults(Object:Journal, Array[3], null, null, null, 500, 1) % line  132, file: SubmissionSearch.inc.php
                                             SubmissionSearch._getMergedArray(Object:Journal, Array[1], null, null) % line  263, file: SubmissionSearch.inc.php
                                          SubmissionSearch.retrieveResults(Object:Request, Object:Journal, Array[1], null, null, null, Object:DBResultRange, Array[1]) % line   92, file: RecommendBySimilarityPlugin.inc.php
                                       RecommendBySimilarityPlugin.callbackTemplateArticlePageFooter(Templates::Article::Footer::PageFooter, Array[3]) % line  107, file: HookRegistry.inc.php
                                    HookRegistry.call(Templates::Article::Footer::PageFooter, Array[3]) % line 1267, file: PKPTemplateManager.inc.php
                                 PKPTemplateManager.smartyCallHook(Array[1], Object:Smarty_Internal_Template) % line   43, file: 42362804174f266c598cdb32c3208fc745b92101^1c372c95cd85572e0fbc9a53d0323a0b229cfc78_0.app.frontendpagesarticle.tpl.php
                              content_6781613650b432_13896783(Object:Smarty_Internal_Template) % line  123, file: smarty_template_resource_base.php
                           Smarty_Template_Resource_Base.getRenderedTemplateCode(Object:Smarty_Internal_Template) % line  114, file: smarty_template_compiled.php
                        Smarty_Template_Compiled.render(Object:Smarty_Internal_Template) % line  216, file: smarty_internal_template.php
                     Smarty_Internal_Template.render(false, 1) % line  232, file: smarty_internal_templatebase.php
                  Smarty_Internal_TemplateBase._execute(Object:Smarty_Internal_Template, null, 42362804174f266c598cdb32c3208fc745b92101, null, 1) % line  134, file: smarty_internal_templatebase.php
               Smarty_Internal_TemplateBase.display(frontend/pages/article.tpl, null, 42362804174f266c598cdb32c3208fc745b92101, null) % line  924, file: PKPTemplateManager.inc.php
            PKPTemplateManager.display(frontend/pages/article.tpl) % line  292, file: ArticleHandler.inc.php
         ArticleHandler.view(Array[1], Object:Request) % line  391, file: PKPRouter.inc.php
      PKPRouter._authorizeInitializeAndCallRequest(Array[2], Object:Request, Array[1], false) % line  231, file: PKPPageRouter.inc.php
   PKPPageRouter.route(Object:Request) % line  143, file: Dispatcher.inc.php
Dispatcher.dispatch(Object:Request) % line  281, file: PKPApplication.inc.php
PKPApplication.execute() % line   68, file: index.php

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