title: Predicting alloreactivity in transplantation.
abstract: Human leukocyte Antigen (HLA) mismatching leads to severe complications after solid-organ transplantation and hematopoietic stem-cell transplantation. The alloreactive responses underlying the posttransplantation complications include both direct recognition of allogeneic HLA by HLA-specific alloantibodies and T cells and indirect T-cell recognition. However, the immunogenicity of HLA mismatches is highly variable; some HLA mismatches lead to severe clinical B-cell- and T-cell-mediated alloreactivity, whereas others are well tolerated. Definition of the permissibility of HLA mismatches prior to transplantation allows selection of donor-recipient combinations that will have a reduced chance to develop deleterious host-versus-graft responses after solid-organ transplantation and graft-versus-host responses after hematopoietic stem-cell transplantation. Therefore, several methods have been developed to predict permissible HLA-mismatch combinations. In this review we aim to give a comprehensive overview about the current knowledge regarding HLA-directed alloreactivity and several developed in vitro and in silico tools that aim to predict direct and indirect alloreactivity.
authors.affiliation: Laboratory for Translational Immunology, UMC Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Geneugelijk
authors.affiliation: Laboratory for Translational Immunology, UMC Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
authors.forename: Kirsten Anne
authors.initials: KA
authors.lastname: Thus
authors.affiliation: Laboratory for Translational Immunology, UMC Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
authors.forename: Eric
authors.initials: E
authors.lastname: Spierings
mesh_terms: D000939:Epitopes / Q000737:chemistry / Q000276:immunology; D006084:Graft Rejection / Q000517:prevention & control*; D006087:Graft vs Host Reaction; D006680:HLA Antigens / Q000737:chemistry / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation; D006650:Histocompatibility Testing / Q000379:methods*; D006789:Host vs Graft Reaction; D006801:Humans; D007074:Immunoglobulin G / Q000096:biosynthesis; D007518:Isoantibodies / Q000096:biosynthesis*; D007962:Leukocytes / Q000166:cytology / Q000276:immunology; D016377:Organ Transplantation; D014184:Transplantation, Homologous
chemical_list: D000939:Epitopes; D006680:HLA Antigens; D007074:Immunoglobulin G; D007518:Isoantibodies