[Challenges of the modern antibody diagnostics in kidney transplantation].
Overcoming antibody mediated rejection is of increasing interest in the field of transplantation immunology. The recipient's antibodies against the graft human leukocyte antigens are responsible for antibody mediated graft injury. Introduction of the solid phase immunoassay technology radically changed the monitoring practice of antibodies against human leukocyte antigens, and this has consequences both for pretransplant and posttransplant phases, though our knowledge about the clinical interpretation of the detected antibodies is limited. This integrating review reports recommendations and algorithms regarding the management of kidney transplant patients. The detection of complement activation combined with the solid phase techniques is a promising new approach in antibody testing. The C4d and especially the more sensitive C1q methods have the potential to answer pivotal questions about the clinical relevance of antibodies. Answering the questions that the applied new methods raised and reviewing the recommendations are needed to remain up to date with this dynamically developing field.
Semmelweis Egyetem, Általános Orvostudományi Kar Transzplantációs és Sebészeti Klinika Budapest.
Dániel
D
Wettstein
Semmelweis Egyetem, Általános Orvostudományi Kar III. Belgyógyászati Klinika Budapest.
Dorottya
D
Szentiványi
D000465:Algorithms; D000906:Antibodies / Q000097:blood* / Q000302:isolation & purification; D015922:Complement C1q / Q000276:immunology*; D015935:Complement C4b / Q000276:immunology*; D005434:Flow Cytometry; D006084:Graft Rejection / Q000276:immunology*; D006085:Graft Survival / Q000276:immunology*; D006680:HLA Antigens / Q000097:blood; D006801:Humans; D016030:Kidney Transplantation; D010446:Peptide Fragments / Q000276:immunology*; D018570:Risk Assessment; D012307:Risk Factors
D000906:Antibodies; D006680:HLA Antigens; D010446:Peptide Fragments; D015922:Complement C1q; D015935:Complement C4b; C032261:complement C4d
HLA antibodies; HLA-antitestek; antibody mediated rejection; antitestmediált rejectio; kidney transplantation; vesetranszplantáció