{"id":2091,"date":"2017-05-23T09:04:35","date_gmt":"2017-05-23T09:04:35","guid":{"rendered":"https:\/\/www.lalpathlabs.com\/blog\/?p=2091"},"modified":"2023-10-12T12:48:49","modified_gmt":"2023-10-12T07:18:49","slug":"histocompatibility-testing-and-antibody-detection-in-solid-organ-transplantation","status":"publish","type":"post","link":"https:\/\/www.lalpathlabs.com\/blog\/histocompatibility-testing-and-antibody-detection-in-solid-organ-transplantation\/","title":{"rendered":"Histocompatibility Testing and Antibody Detection in Solid Organ Transplantation"},"content":{"rendered":"

\"hla<\/p>\n

\"Histocompatibility<\/h2>\n

Histocompatibility Testing plays an important role in determining the degree of Human Leukocyte Antigen (MLA) matching between the solid organ recipients and their donors (12). It also includes the donor-recipient Cross-match Testing (XMT) and anti-HLA antibody screening that are crucial examinations in solid organ transplantation, aiming to avoid hyperacute graft rejection and also to predict the immunological outcome of the graft(3.5).<\/p>\n

An individual can become sensitized to HLA allo-antigens as a result of blood transfusion<\/a><\/span>, pregnancy or previous organ transplantation. Transplantation of poorly HLA-matched kidneys can result in allosensitization to the mis-matched donor HLA. Approximately 20% of pregnant women produce HLA-specific antibodies<\/a><\/span> to paternally inherited fetal HLA antigens.<\/p>\n

Pre transplant risk assessment in solid organ transplantation is important for the selection of the donor to initiate appropriate treatment strategies.<\/p>\n

\"risk\"<\/p>\n

\u2022 High immunological risk <\/span><\/strong><\/span>
\n\u2022 High titre circulating antibodies specific for mismatched donor antigens present at the time of transplantation
\n\u2022 High risk of rejection<\/p>\n

\u2022 Intermediate immunological risk<\/strong> <\/span>
\n\u2022 Prior donor reactive sensitization
\n\u2022 Weak sensitization to certain mismatched HLA specificities only<\/p>\n

\u2022 Low (or standard) immunological risk<\/strong> <\/span>
\n\u2022 Non-sensitized patients
\n\u2022 Sensitized patients-minimally HLA mismatched organ in absence of known current or historical donor reactive antibodies<\/p>\n

\"risk<\/p>\n

 <\/p>\n

\"antibody<\/p>\n

\"solid<\/p>\n

\"sensitized<\/p>\n

\"kidney<\/p>\n

\"pre<\/p>\n

\"hla<\/p>\n

References<\/strong><\/span><\/p>\n

1. Claas FHJ, Dankers MK, Oudshoorn M, van Rood JJ, Mulder A, Roelen DL, et al. Differential immunogenicity of HLA mismatches in clinical transplantation.Transpl Immun.<\/p>\n

2. Cecka JM. HLA matching for organ transplantation…Why not? Int J Immunogenet.<\/p>\n

3. Patel R, Terasaki Pl. Significance of the positive crossmatch in kidney transplantation. N Engl J Med.<\/p>\n

4. Billen EV, Christiaans MH, van den Berg-Loonen EM. Clinical relevance of Luminex donor-specific crossmatches: data from 165 renal transplants.Tissue Antigens.<\/p>\n

5. Batal I, Zeevi A, Lunz JG, III, Aggarwal N, Shapiro R, Randhawa P, et al. Antihuman leukocyte antigen-specific antibody strength determined by complement-dependent or solid-phase assays can predict positive donor-specific crossmatches. Arch Pathol Lab Med. 2010;34:1534-40.<\/p>\n

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