Should HLA mismatch acceptability for sensitized transplant candidates be determined at the high-resolution rather than the antigen level?

R. J. Duquesnoy*, M. Kamoun, L. A. Baxter-Lowe, E. S. Woodle, R. A. Bray, F. H J Claas, D. D. Eckels, J. J. Friedewald, S. V. Fuggle, H. M. Gebel, J. A. Gerlach, J. J. Fung, D. Middleton, P. Nickerson, R. Shapiro, A. R. Tambur, C. J. Taylor, K. Tinckam, A. Zeevi

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

52 Scopus citations

Abstract

Defining HLA mismatch acceptability of organ transplant donors for sensitized recipients has traditionally been based on serologically defined HLA antigens. Now, however, it is well accepted that HLA antibodies specifically recognize a wide range of epitopes present on HLA antigens and that molecularly defined high resolution alleles corresponding to the same low resolution antigen can possess different epitope repertoires. Hence, determination of HLA compatibility at the allele level represents a more accurate approach to identify suitable donors for sensitized patients. This approach would offer opportunities for increased transplant rates and improved long term graft survivals. Considering the convincing evidence that HLA antibodies specifically recognize epitopes shared between alleles, this group of investigators offers a scientific argument for the advantage of assessing HLA compatibility at the high-resolution level. See editorial by Cecka et al on page 855.

Original languageEnglish (US)
Pages (from-to)923-930
Number of pages8
JournalAmerican Journal of Transplantation
Volume15
Issue number4
DOIs
StatePublished - Apr 1 2015

Keywords

  • Alloantibody
  • immunogenetics
  • major histocompatibility complex (MHC)
  • panel reactive antibody (PRA)
  • sensitization

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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