PMID- 31789952
OWN - NLM
STAT- MEDLINE
DCOM- 20201023
LR  - 20210206
IS  - 1531-7013 (Electronic)
IS  - 1087-2418 (Linking)
VI  - 25
IP  - 1
DP  - 2020 Feb
TI  - Human leukocyte antigen molecular mismatch to risk stratify kidney transplant 
      recipients.
PG  - 8-14
LID - 10.1097/MOT.0000000000000714 [doi]
AB  - PURPOSE OF REVIEW: Stalled drug development and the lack of improvement in 
      long-term graft survival reflect the unmet need for prognostic and predictive 
      biomarkers in transplantation. Although conventional human leukocyte antigen 
      (HLA) mismatch is too imprecise to fulfill this need, HLA molecular mismatch 
      increases the precision in alloimmune risk assessment by quantifying the 
      difference between donors and recipients at the molecular level. RECENT FINDINGS: 
      Within each conventional HLA mismatch, recipients exhibit a wide range of HLA 
      molecular mismatches with their donors. Quantifying HLA molecular mismatch 
      improves the precision of alloimmune risk assessment for de novo donor-specific 
      antibody development (dnDSA). Alloimmune risk categories developed analyzing 
      dnDSA development were also found to correlate with T-cell-mediated rejection, 
      antibody-mediated rejection, and all cause graft loss in adjusted and unadjusted 
      models. SUMMARY: All alloimmunity is driven by differences between donors and 
      recipients at the molecular level. HLA molecular mismatch may represent a fast, 
      reproducible, cost-effective, way to improve alloimmune risk assessment at the 
      time of transplantation to move the field towards precision medicine.
FAU - Wiebe, Chris
AU  - Wiebe C
AD  - Department of Medicine, University of Manitoba.
AD  - Shared Health Services Manitoba.
AD  - Department of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada.
FAU - Nickerson, Peter W
AU  - Nickerson PW
AD  - Department of Medicine, University of Manitoba.
AD  - Shared Health Services Manitoba.
AD  - Department of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada.
LA  - eng
GR  - CIHR/Canada
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Curr Opin Organ Transplant
JT  - Current opinion in organ transplantation
JID - 9717388
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Female
MH  - HLA Antigens/*immunology
MH  - Histocompatibility Testing/*methods
MH  - Humans
MH  - Kidney Transplantation/*methods
MH  - Male
MH  - Risk Factors
EDAT- 2019/12/04 06:00
MHDA- 2020/10/24 06:00
CRDT- 2019/12/03 06:00
PHST- 2019/12/04 06:00 [pubmed]
PHST- 2020/10/24 06:00 [medline]
PHST- 2019/12/03 06:00 [entrez]
AID - 00075200-202002000-00003 [pii]
AID - 10.1097/MOT.0000000000000714 [doi]
PST - ppublish
SO  - Curr Opin Organ Transplant. 2020 Feb;25(1):8-14. doi: 
      10.1097/MOT.0000000000000714.