title: Should HLA mismatch acceptability for sensitized transplant candidates be determined at the high-resolution rather than the antigen level?
abstract: Defining HLA mismatch acceptability of organ transplant donors for sensitized recipients has traditionally been based on serologically defined HLA antigens. Now, however, it is well accepted that HLA antibodies specifically recognize a wide range of epitopes present on HLA antigens and that molecularly defined high resolution alleles corresponding to the same low resolution antigen can possess different epitope repertoires. Hence, determination of HLA compatibility at the allele level represents a more accurate approach to identify suitable donors for sensitized patients. This approach would offer opportunities for increased transplant rates and improved long term graft survivals.
authors.affiliation: Thomas E.Starzl Transplantation Institute, University of Pittsburgh, Medical Center, Pittsburgh, PA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Duquesnoy
authors.forename: M
authors.initials: M
authors.lastname: Kamoun
authors.forename: L A
authors.initials: LA
authors.lastname: Baxter-Lowe
authors.forename: E S
authors.initials: ES
authors.lastname: Woodle
authors.forename: R A
authors.initials: RA
authors.lastname: Bray
authors.forename: F H J
authors.initials: FH
authors.lastname: Claas
authors.forename: D D
authors.initials: DD
authors.lastname: Eckels
authors.forename: J J
authors.initials: JJ
authors.lastname: Friedewald
authors.forename: S V
authors.initials: SV
authors.lastname: Fuggle
authors.forename: H M
authors.initials: HM
authors.lastname: Gebel
authors.forename: J A
authors.initials: JA
authors.lastname: Gerlach
authors.forename: J J
authors.initials: JJ
authors.lastname: Fung
authors.forename: D
authors.initials: D
authors.lastname: Middleton
authors.forename: P
authors.initials: P
authors.lastname: Nickerson
authors.forename: R
authors.initials: R
authors.lastname: Shapiro
authors.forename: A R
authors.initials: AR
authors.lastname: Tambur
authors.forename: C J
authors.initials: CJ
authors.lastname: Taylor
authors.forename: K
authors.initials: K
authors.lastname: Tinckam
authors.forename: A
authors.initials: A
authors.lastname: Zeevi
mesh_terms: D000483:Alleles; D001323:Autoantibodies / Q000276:immunology; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D007108:Immune Tolerance; D014019:Tissue Donors; D014181:Transplantation Immunology
chemical_list: D001323:Autoantibodies; D006680:HLA Antigens
keywords: Alloantibody; immunogenetics; major histocompatibility complex (MHC); panel reactive antibody (PRA); sensitization