PMID- 19417655
OWN - NLM
STAT- MEDLINE
DCOM- 20090924
LR  - 20090715
IS  - 1531-7013 (Electronic)
IS  - 1087-2418 (Linking)
VI  - 14
IP  - 4
DP  - 2009 Aug
TI  - The role of the histocompatibility laboratory in desensitization for 
      transplantation.
PG  - 398-402
LID - 10.1097/MOT.0b013e32832c5983 [doi]
AB  - PURPOSE OF REVIEW: The ability of histocompatibility laboratories to define and 
      monitor human leukocyte antigen (HLA)-specific antibodies via highly sensitive 
      immunoassays has been a major contributing factor in the development of 
      desensitization protocols for HLA-incompatible transplants. This review will 
      focus on the laboratory's role in desensitization and the types of tests needed 
      for determining the specificity and strength of antibodies to donor HLA 
      pretransplant, during treatment, and after transplant. RECENT FINDINGS: 
      Increasingly, solid-phase immunoassays that use purified HLA molecules are 
      providing sensitive characterization of HLA-specific antibodies. Assay 
      parameters, such as median fluorescence intensity, can be correlated with 
      cross-match results and clinical outcomes, and subsequently used to monitor 
      antibody status in patients undergoing desensitization. The strength of donor 
      HLA-specific antibody, measured by cross-match and/or solid phase assays, is used 
      to determine the likelihood of successful desensitization, as well as the risk of 
      posttransplant antibody-mediated rejection. SUMMARY: Histocompatibility 
      laboratories are essential components of desensitization programs. Thorough 
      antibody characterization and serial monitoring of changes in antibody status are 
      needed pretreatment, during treatment and after transplant. Because clinical 
      decisions rely heavily on changes in antibody specificity and strength, 
      desensitization should not be undertaken without access to appropriate 
      histocompatibility testing.
FAU - Leffell, Mary S
AU  - Leffell MS
AD  - Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, 
      MD 21205, USA. msl@jhmi.edu
FAU - Zachary, Andrea A
AU  - Zachary AA
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Opin Organ Transplant
JT  - Current opinion in organ transplantation
JID - 9717388
RN  - 0 (Antibodies)
RN  - 0 (HLA Antigens)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Antibodies/blood
MH  - Antibody Specificity
MH  - *Desensitization, Immunologic/methods
MH  - Graft Rejection/immunology/prevention & control
MH  - HLA Antigens/immunology
MH  - *Histocompatibility
MH  - *Histocompatibility Testing/methods
MH  - Humans
MH  - Immunoassay
MH  - Immunoglobulins, Intravenous/therapeutic use
MH  - Immunosuppressive Agents/therapeutic use
MH  - *Laboratories
MH  - *Organ Transplantation/adverse effects
MH  - Plasmapheresis
MH  - *Tissue Donors
MH  - Treatment Outcome
RF  - 30
EDAT- 2009/05/07 09:00
MHDA- 2009/09/25 06:00
CRDT- 2009/05/07 09:00
PHST- 2009/05/07 09:00 [entrez]
PHST- 2009/05/07 09:00 [pubmed]
PHST- 2009/09/25 06:00 [medline]
AID - 10.1097/MOT.0b013e32832c5983 [doi]
PST - ppublish
SO  - Curr Opin Organ Transplant. 2009 Aug;14(4):398-402. doi: 
      10.1097/MOT.0b013e32832c5983.