PMID- 23838652
OWN - NLM
STAT- MEDLINE
DCOM- 20130919
LR  - 20151119
IS  - 1531-7013 (Electronic)
IS  - 1087-2418 (Linking)
VI  - 18
IP  - 4
DP  - 2013 Aug
TI  - Clinical relevance of human leukocyte antigen antibodies in liver, heart, lung 
      and intestine transplantation.
PG  - 463-9
LID - 10.1097/MOT.0b013e3283636c71 [doi]
AB  - PURPOSE OF REVIEW: Solid phase assays identify human leukocyte antigen (HLA) 
      antibodies with a great sensitivity. Whether to accept or decline an organ if the 
      virtual crossmatch is positive, when to monitor and whether to treat de-novo 
      donor-specific antibody (DSA) posttransplant remain challenging issues for the 
      transplant clinician. RECENT FINDINGS: Technologies that can differentiate which 
      antibodies pose the greatest risk for antibody-mediated rejection (AMR) are 
      evolving. Complement fixing luminex assays have been used to predict high-risk 
      antibodies, but using these assays alone will miss some preformed antibodies. How 
      these technologies fit into the laboratory's testing algorithm will likely need 
      to be individualized. Posttransplant de-novo DSAs are associated with inferior 
      outcomes. In hearts, similar to renal transplantation, acute rejection is a risk 
      factor for developing de-novo DSA. Further data are needed to determine whether 
      other risk factors are similar to those reported for renal transplants. 
      Antibodies to self-antigens are increasingly recognized posttransplant and how 
      the alloimmune response contributes to altered autoregulation is a current 
      research focus. SUMMARY: Identification of DSA enables the clinician to make 
      informed decisions regarding whether or not to accept an organ and if augmented 
      immunosuppression is indicated. Monitoring for DSA posttransplant identifies 
      recipients at a greater risk for AMR and can guide management. However, the best 
      approach to dealing with de-novo DSA remains unclear.
FAU - Campbell, Patricia
AU  - Campbell P
AD  - Department of Medicine and Laboratory Medicine, University of Alberta, Edmonton, 
      Alberta, Canada. trish.campbell@ualberta.ca
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 (Biomarkers)
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Biomarkers
MH  - HLA Antigens/*immunology
MH  - Heart Transplantation/*immunology
MH  - Histocompatibility Testing
MH  - Humans
MH  - Intestines/*transplantation
MH  - Isoantibodies/*blood
MH  - Liver Transplantation/*immunology
MH  - Lung Transplantation/*immunology
MH  - Tissue Donors
EDAT- 2013/07/11 06:00
MHDA- 2013/09/21 06:00
CRDT- 2013/07/11 06:00
PHST- 2013/07/11 06:00 [entrez]
PHST- 2013/07/11 06:00 [pubmed]
PHST- 2013/09/21 06:00 [medline]
AID - 00075200-201308000-00013 [pii]
AID - 10.1097/MOT.0b013e3283636c71 [doi]
PST - ppublish
SO  - Curr Opin Organ Transplant. 2013 Aug;18(4):463-9. doi: 
      10.1097/MOT.0b013e3283636c71.