PMID- 35669972
OWN - NLM
STAT- MEDLINE
DCOM- 20220608
LR  - 20220716
IS  - 1432-2277 (Electronic)
IS  - 0934-0874 (Print)
IS  - 0934-0874 (Linking)
VI  - 35
DP  - 2022
TI  - Alloimmune Risk Stratification for Kidney Transplant Rejection.
PG  - 10138
LID - 10.3389/ti.2022.10138 [doi]
LID - 10138
AB  - Different types of kidney transplantations are performed worldwide, including 
      biologically diverse donor/recipient combinations, which entail distinct 
      patient/graft outcomes. Thus, proper immunological and non-immunological risk 
      stratification should be considered, especially for patients included in 
      interventional randomized clinical trials. This paper was prepared by a working 
      group within the European Society for Organ Transplantation, which submitted a 
      Broad Scientific Advice request to the European Medicines Agency (EMA) relating 
      to clinical trial endpoints in kidney transplantation. After collaborative 
      interactions, the EMA sent its final response in December 2020, highlighting the 
      following: 1) transplantations performed between human leukocyte antigen 
      (HLA)-identical donors and recipients carry significantly lower immunological 
      risk than those from HLA-mismatched donors; 2) for the same allogeneic molecular 
      HLA mismatch load, kidney grafts from living donors carry significantly lower 
      immunological risk because they are better preserved and therefore less 
      immunogenic than grafts from deceased donors; 3) single-antigen bead testing is 
      the gold standard to establish the repertoire of serological sensitization and is 
      used to define the presence of a recipient's circulating donor-specific 
      antibodies (HLA-DSA); 4) molecular HLA mismatch analysis should help to further 
      improve organ allocation compatibility and stratify immunological risk for 
      primary alloimmune activation, but without consensus regarding which algorithm 
      and cut-off to use it is difficult to integrate information into clinical 
      practice/study design; 5) further clinical validation of other immune assays, 
      such as those measuring anti-donor cellular memory (T/B cell ELISpot assays) and 
      non-HLA-DSA, is needed; 6) routine clinical tests that reliably measure innate 
      immune alloreactivity are lacking.
CI  - Copyright (c) 2022 Bestard, Thaunat, Bellini, Bohmig, Budde, Claas, Couzi, Furian, 
      Heemann, Mamode, Oberbauer, Pengel, Schneeberger and Naesens.
FAU - Bestard, Oriol
AU  - Bestard O
AD  - Department of Nephrology and Kidney Transplantation, Vall d'Hebron University 
      Hospital, Barcelona, Spain.
FAU - Thaunat, Olivier
AU  - Thaunat O
AD  - Department of Transplantation, Nephrology, and Clinical Immunology, Edouard 
      Herriot Hospital, Hospices Civils de Lyon, Lyon, France.
FAU - Bellini, Maria Irene
AU  - Bellini MI
AD  - Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy.
FAU - Bohmig, Georg A
AU  - Bohmig GA
AD  - Department of Nephrology and Dialysis, Medical University of Vienna, Vienna, 
      Austria.
FAU - Budde, Klemens
AU  - Budde K
AD  - Department of Nephrology and Medical Intensive Care, Charite Universitatsmedizin 
      Berlin, Berlin, Germany.
FAU - Claas, Frans
AU  - Claas F
AD  - Eurotransplant Reference Laboratory, Department of Immunology, Leiden University 
      Medical Center, Leiden, Netherlands.
FAU - Couzi, Lionel
AU  - Couzi L
AD  - Department of Nephrology, Transplantation and Dialysis, Bordeaux University 
      Hospital, Bordeaux, France.
FAU - Furian, Lucrezia
AU  - Furian L
AD  - Kidney and Pancreas Transplantation Unit, University of Padua, Padua, Italy.
FAU - Heemann, Uwe
AU  - Heemann U
AD  - Department of Nephrology, Technical University of Munich, Munich, Germany.
FAU - Mamode, Nizam
AU  - Mamode N
AD  - Department of Transplantation, Guy's and St Thomas' NHS Foundation Trust, London, 
      United Kingdom.
FAU - Oberbauer, Rainer
AU  - Oberbauer R
AD  - Department of Nephrology and Dialysis, Medical University of Vienna, Vienna, 
      Austria.
FAU - Pengel, Liset
AU  - Pengel L
AD  - Centre for Evidence in Transplantation, Nuffield Department of Surgical Sciences, 
      University of Oxford, Oxford, United Kingdom.
FAU - Schneeberger, Stefan
AU  - Schneeberger S
AD  - Department of General, Transplant, and Thoracic Surgery, Medical University of 
      Innsbruck, Innsbruck, Austria.
FAU - Naesens, Maarten
AU  - Naesens M
AD  - Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, 
      Belgium.
LA  - eng
PT  - Editorial
DEP - 20220520
PL  - Switzerland
TA  - Transpl Int
JT  - Transplant international : official journal of the European Society for Organ 
      Transplantation
JID - 8908516
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Graft Rejection
MH  - Graft Survival
MH  - HLA Antigens
MH  - Histocompatibility Testing
MH  - Humans
MH  - *Kidney Transplantation
MH  - Living Donors
MH  - Risk Assessment
MH  - Tissue Donors
PMC - PMC9163827
OTO - NOTNLM
OT  - alloimmune risk
OT  - crossmatch
OT  - high-risk transplantation
OT  - individualized immunosuppression
OT  - molecular HLA mismatch
COIS- OB has received research funding from Chiesi and served as adviser for Hansa 
      Biopharma. OT has received research funding from bioMerieux, Bristol Myers 
      Squibb, and Immucor; and has consultancy agreements with Biotest and Novartis. GB 
      has received honoraria and/or research funding from Astellas, CareDx, CSL 
      Behring, Fresenius, Hansa, Neovii, and Vitaeris. KB has received honoraria and/or 
      research funding from Alexion, Astellas, Bristol Myers Squibb, Chiesi, Fresenius, 
      Hansa, Hexal, Merck, Novartis, Otsuka, Pfizer, Roche, Sandoz, Siemens, and 
      Veloxis. FC is a scientific adviser for GenDx and Immucor. LF has received 
      honoraria and/or research funding from Astellas, Chiesi, Hansa, and Novartis. UH 
      has received grants/research support from Baxter, Chiesi, and Neovii; speakers' 
      bureaux/honoraria from Chiesi and Hansa; and consulting fees from Astellas, 
      Hansa, Neovii, Novartis, and Teva. NM has received honoraria from Hansa, Chiesi, 
      Novartis, and Takeda. RO has received grants/research support from Amgen, 
      Astellas, and Chiesi; and speakers' bureaux/honoraria from Amgen, Astellas, 
      Chiesi, Hansa, Neovii, Novartis, and Teva. SS has received grants/research 
      support from Bridge to Life, Chiesi, Neovii, Novartis, Organ Recovery Systems, 
      and Sandoz; speakers' bureaux/honoraria from Astellas, BMS, Chiesi, Novartis, 
      OrganOx, and Sanofi; and consulting fees from Astellas, Atara, Merck, 
      NefroHealth, Novartis, Sandoz, and Teva. The remaining authors declare that the 
      work was conducted in the absence of any commercial or financial relationships 
      that could be construed as a potential conflict of interest.
EDAT- 2022/06/08 06:00
MHDA- 2022/06/09 06:00
PMCR- 2022/05/20
CRDT- 2022/06/07 02:50
PHST- 2021/10/21 00:00 [received]
PHST- 2022/01/26 00:00 [accepted]
PHST- 2022/06/07 02:50 [entrez]
PHST- 2022/06/08 06:00 [pubmed]
PHST- 2022/06/09 06:00 [medline]
PHST- 2022/05/20 00:00 [pmc-release]
AID - 10138 [pii]
AID - 10.3389/ti.2022.10138 [doi]
PST - epublish
SO  - Transpl Int. 2022 May 20;35:10138. doi: 10.3389/ti.2022.10138. eCollection 2022.