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.
- major histocompatibility complex (MHC)
- panel reactive antibody (PRA)
ASJC Scopus subject areas
- Immunology and Allergy
- Pharmacology (medical)