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Role of non-HLA antibodies in organ transplantation.

Abstract

PURPOSE OF REVIEW
Humoral responses beyond major histocompatibility antigens receive an increased attention of the transplantation community. We aimed to summarize the data on discovery of new antigenic targets, novel experimental findings, recent diagnostic developments, and introduction of new technologies in the field of non-HLA antigens in solid organ transplantation.
RECENT FINDINGS
Non-HLA antibodies can be currently reliably detected by solid-phase assays (MICA, angiotensin type 1 receptor, collagen-V, vimentin), immunofluorescence (antibodies against antigens expressed on umbilical vein endothelial cells), or flow-crossmatch techniques (antibodies against donor endothelial progenitors). Influence of test positivity on transplant outcomes is variable and differs among non-HLA targets. Use of omics approach helped to identify a unique set of antigens in adult and pediatric patients with severe rejections and transplant glomerulopathy.
SUMMARY
Paradigms for effective monitoring of non-HLA humoral responses need to be established in order to utilize advances provided by the rapid diagnostic developments. A systematic longitudinal assessment of pretransplant sensitization together with monitoring of posttransplant changes would represent an important step forward.

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  • Publisher Full Text
  • Authors

    Dragun D, Philippe A, Catar R

    Institution

    Clinic for Nephrology and Intensive Care Medicine, Campus Virchow-Klinikum and Center for Cardiovascular Research, Medical Faculty of the Charité Berlin, Berlin, Germany. duska.dragun@charite.de

    Source

    Current opinion in organ transplantation 17:4 2012 Aug pg 440-5

    MeSH

    Antibodies
    Endothelial Cells
    Extracellular Matrix Proteins
    Graft Rejection
    HLA Antigens
    Histocompatibility Antigens Class I
    Humans
    Immunity, Humoral
    Intermediate Filaments
    Organ Transplantation
    Receptor, Angiotensin, Type 1

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    22790079