Human Leukocyte Antigen Sensitization in Solid Organ Transplantation: A Primer on Terminology, Testing, and Clinical Significance for the Apheresis Practitioner

被引:11
作者
Abbes, Sarah [1 ,2 ,3 ]
Metjian, Ara [3 ]
Gray, Alice [4 ]
Martinu, Tereza [4 ,7 ]
Snyder, Laurie [4 ]
Chen, Dong-feng [5 ]
Ellis, Matthew [6 ]
Arepally, Gowthami M. [3 ]
Onwuemene, Oluwatoyosi [3 ]
机构
[1] Ctr Hosp Univ, Inst Thorax, Serv Pneumol, Nantes, France
[2] Ctr Hosp Univ, Unite Transplantat Thorac, Nantes, France
[3] Duke Univ, Sch Med, Dept Med, Div Hematol, Durham, NC 27706 USA
[4] Duke Univ, Sch Med, Dept Med, Div Pulm Allergy & Crit Care Med, Durham, NC 27706 USA
[5] Duke Univ, Sch Med, Dept Pathol, Div Pathol Clin Serv, Durham, NC 27706 USA
[6] Duke Univ, Sch Med, Dept Med, Div Nephrol, Durham, NC 27706 USA
[7] Univ Toronto, Div Respirol, Dept Med, Toronto, ON, Canada
关键词
Human leukocyte antigen antibodies; Human leukocyte antigen sensitization; Solid organ transplantation; Therapeutic plasma exchange; VIRTUAL CROSS-MATCH; DONOR-SPECIFIC ANTIBODIES; HLA-SPECIFIC ANTIBODIES; LUNG ALLOGRAFT DYSFUNCTION; SINGLE-CENTER EXPERIENCE; KIDNEY-TRANSPLANTATION; CLASS-I; HEART-TRANSPLANTATION; MEDIATED REJECTION; AMERICAN-SOCIETY;
D O I
10.1111/1744-9987.12570
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The human leukocyte antigen (HLA) system is an important immunologic barrier that must be considered for successful solid organ transplantation. Formation of donor-specific HLA antibodies in solid organ transplantation is an important cause of allograft injury and may contribute to recipient morbidity and mortality. Therapeutic plasma exchange is often requested to lower HLA antibody levels prior to or after transplantation and for management of HLA antibodies in the context of organ rejection. In this review, we summarize the current terminology, laboratory testing, and clinical significance of HLA sensitization in the solid organ transplant population. Furthermore, to illustrate applications of HLA testing in clinical practice, we summarize our own lung and kidney institutional protocols for managing HLA antibodies in the peri-transplant setting.
引用
收藏
页码:441 / 450
页数:10
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