Anti-HLA alloantibodies in pediatric solid organ transplantation.
An increasing number of studies demonstrate the clinical impact of preformed and de novo anti-human leucocyte antigen alloantibody (HLA-Ab) in solid organ transplantation (Tx). The screening of HLA-Ab in candidates and transplant recipients has evolved over time, with continuous improvement in the sensitivity and specificity of assays for HLA-Ab detection. Furthermore, histologic markers of complement activation pathways are currently implemented in the diagnosis of antibody-mediated rejection (AMR). Therapeutic strategies, including depletion of HLA-Ab and B cells, have allowed Tx across antibody barriers, or have rescued patients with AMR. The purpose of the present review is to summarize the state-of-the-art of HLA-Ab detection, clinical significance and therapeutic strategies in pediatric solid organ Tx.
Girnita
Alin L
AL
Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA.
Webber
Steven A
SA
Zeevi
Adriana
A
D002648:Child; D003601:Cytotoxicity Tests, Immunologic; D004797:Enzyme-Linked Immunosorbent Assay; D005434:Flow Cytometry; D006680:HLA Antigens / Q000276:immunology*; D016027:Heart Transplantation / Q000276:immunology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D007518:Isoantibodies / Q000276:immunology*; D016030:Kidney Transplantation / Q000276:immunology; D016031:Liver Transplantation / Q000276:immunology; D014181:Transplantation Immunology / Q000276:immunology*; D014184:Transplantation, Homologous
D006680:HLA Antigens; D016756:Immunoglobulins, Intravenous; D007518:Isoantibodies