title: Detection and clinical relevance of donor specific HLA antibodies: a matter of debate.
abstract: The introduction of new sensitive assays for the detection of HLA antibodies on basis of their binding to isolated HLA molecules has got an enormous impact on the decision-making process with respect to donor selection for sensitized patients. In the past, when only complement-dependent cytotoxicity was used as a tool to define HLA alloantibodies, the presence of donor specific antibodies (DSA) before transplantation was considered a contraindication for renal transplantation with that donor. The interpretation of the current DSA results is far more difficult and leads to a lot of discussions and controversy. The problems associated with the use of solid phase assays for clinical decision making and possible solutions are discussed.
authors.affiliation: Leiden University Medical Center, Department Immunohaematology and Blood Transfusion, Leiden, The Netherlands.
authors.forename: Dave L
authors.initials: DL
authors.lastname: Roelen
authors.forename: Ilias I N
authors.initials: II
authors.lastname: Doxiadis
authors.forename: Frans H J
authors.initials: FH
authors.lastname: Claas
mesh_terms: D015415:Biomarkers / Q000097:blood; D000075202:Contraindications; D004797:Enzyme-Linked Immunosorbent Assay; D006084:Graft Rejection / Q000097:blood / Q000276:immunology* / Q000517:prevention & control; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007159:Immunologic Tests; D007518:Isoantibodies / Q000097:blood* / Q000276:immunology; D016030:Kidney Transplantation / Q000276:immunology*; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D006680:HLA Antigens; D007518:Isoantibodies