PMID- 32520786
OWN - NLM
STAT- MEDLINE
DCOM- 20210128
LR  - 20240330
IS  - 1531-7013 (Electronic)
IS  - 1087-2418 (Print)
IS  - 1087-2418 (Linking)
VI  - 25
IP  - 4
DP  - 2020 Aug
TI  - Precision transplant pathology.
PG  - 412-419
LID - 10.1097/MOT.0000000000000772 [doi]
AB  - PURPOSE OF REVIEW: Transplant pathology contributes substantially to personalized 
      treatment of organ allograft recipients. Rapidly advancing next-generation human 
      leukocyte antigen (HLA) sequencing and pathology are enhancing the abilities to 
      improve donor/recipient matching and allograft monitoring. RECENT FINDINGS: The 
      present review summarizes the workflow of a prototypical patient through a 
      pathology practice, highlighting histocompatibility assessment and pathologic 
      review of tissues as areas that are evolving to incorporate next-generation 
      technologies while emphasizing critical needs of the field. SUMMARY: Successful 
      organ transplantation starts with the most precise pratical donor-recipient 
      histocompatibility matching. Next-generation sequencing provides the highest 
      resolution donor-recipient matching and enables eplet mismatch scores and more 
      precise monitoring of donor-specific antibodies (DSAs) that may arise after 
      transplant. Multiplex labeling combined with hand-crafted machine learning is 
      transforming traditional histopathology. The combination of traditional 
      blood/body fluid laboratory tests, eplet and DSA analysis, traditional and 
      next-generation histopathology, and -omics-based platforms enables risk 
      stratification and identification of early subclinical molecular-based changes 
      that precede a decline in allograft function. Needs include software integration 
      of data derived from diverse platforms that can render the most accurate 
      assessment of allograft health and needs for immunosuppression adjustments.
FAU - Wood-Trageser, Michelle A
AU  - Wood-Trageser MA
AD  - Thomas E. Starzl Transplantation Institute, University of Pittsburgh.
AD  - Division of Liver and Transplantation Pathology, Department of Pathology, 
      University of Pittsburgh, Pennsylvania, USA.
FAU - Xu, Qinyong
AU  - Xu Q
AD  - Thomas E. Starzl Transplantation Institute, University of Pittsburgh.
AD  - Division of Liver and Transplantation Pathology, Department of Pathology, 
      University of Pittsburgh, Pennsylvania, USA.
FAU - Zeevi, Adriana
AU  - Zeevi A
AD  - Thomas E. Starzl Transplantation Institute, University of Pittsburgh.
AD  - Division of Liver and Transplantation Pathology, Department of Pathology, 
      University of Pittsburgh, Pennsylvania, USA.
FAU - Randhawa, Parmjeet
AU  - Randhawa P
AD  - Thomas E. Starzl Transplantation Institute, University of Pittsburgh.
AD  - Division of Liver and Transplantation Pathology, Department of Pathology, 
      University of Pittsburgh, Pennsylvania, USA.
FAU - Lesniak, Drew
AU  - Lesniak D
AD  - Thomas E. Starzl Transplantation Institute, University of Pittsburgh.
AD  - Division of Liver and Transplantation Pathology, Department of Pathology, 
      University of Pittsburgh, Pennsylvania, USA.
FAU - Demetris, Anthony J
AU  - Demetris AJ
AD  - Thomas E. Starzl Transplantation Institute, University of Pittsburgh.
AD  - Division of Liver and Transplantation Pathology, Department of Pathology, 
      University of Pittsburgh, Pennsylvania, USA.
LA  - eng
GR  - R01 DK114180/DK/NIDDK NIH HHS/United States
GR  - U01 AI104347/AI/NIAID NIH HHS/United States
GR  - U19 AI131453/AI/NIAID NIH HHS/United States
GR  - UM1 AI109565/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
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  - HLA Antigens/immunology
MH  - Histocompatibility Testing
MH  - Humans
MH  - Organ Transplantation/*methods
MH  - Precision Medicine/*methods
MH  - Tissue Donors
MH  - Transplantation Immunology
MH  - Transplantation, Homologous
MH  - Transplants/immunology/pathology
PMC - PMC7737245
MID - NIHMS1651333
COIS- Conflict of interest: The authors of this manuscript have conflicts of interest 
      to disclose. Anthony J. Demetris: Receives research support from Q2 Solutions and 
      is a member of an Adjudication Committee for Novartis. None of these conflicts 
      are relevant to this article. The other authors have no conflicts of interest to 
      disclose.
EDAT- 2020/06/11 06:00
MHDA- 2021/01/29 06:00
PMCR- 2021/08/01
CRDT- 2020/06/11 06:00
PHST- 2020/06/11 06:00 [pubmed]
PHST- 2021/01/29 06:00 [medline]
PHST- 2020/06/11 06:00 [entrez]
PHST- 2021/08/01 00:00 [pmc-release]
AID - 00075200-202008000-00018 [pii]
AID - 10.1097/MOT.0000000000000772 [doi]
PST - ppublish
SO  - Curr Opin Organ Transplant. 2020 Aug;25(4):412-419. doi: 
      10.1097/MOT.0000000000000772.