Clinical relevance of antibody development in renal transplantation

The detection and characterization of anti‐HLA antibodies and the clinical impact of their appearance following renal transplantation are areas of immense interest. In particular, de novo development of donor‐specific antibodies (DSA) has been associated with acute and chronic antibody‐mediated graf...

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Bibliographic Details
Published in:Annals of the New York Academy of Sciences 2013-04, Vol.1283 (1), p.30-42
Main Authors: Mehra, Narinder K., Siddiqui, Jamshaid, Baranwal, Ajay, Goswami, Sanjeev, Kaur, Gurvinder
Format: Article
Language:English
Subjects:
Adolescent
Antibodies
donor-specific antibodies
Endothelial cells
Female
graft rejection
HLA Antigens - immunology
Humans
Immunology
Isoantibodies - biosynthesis
Kidney Transplantation - adverse effects
Kidney Transplantation - immunology
Monitoring
non-HLA antibodies
Rejection
renal transplantation
Risk assessment
Solid phases
Survival
Transplantation
Transplants & implants
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Summary:The detection and characterization of anti‐HLA antibodies and the clinical impact of their appearance following renal transplantation are areas of immense interest. In particular, de novo development of donor‐specific antibodies (DSA) has been associated with acute and chronic antibody‐mediated graft rejection (AMR). Recently, methods for antibody detection have evolved remarkably from conventional cell‐based assays to advanced solid phase systems. These systems have revolutionized the art of defining clinically relevant antibodies that are directed toward a renal graft. While anti‐HLA DSAs have been widely associated with poor graft survival, the role of non‐HLA antibodies, particularly those directed against endothelial cells, is beginning to be realized. Appreciation of the mechanisms underlying T cell recognition of alloantigens has generated great interest in the use of synthetic peptides to prevent graft rejection. Hopefully, continued progress in unraveling the molecular mechanisms of graft rejection and posttransplant monitoring of antibodies using highly sensitive testing systems will prove beneficial to immunological risk assessment and early prediction of renal allograft failure.
ISSN:0077-8923
1749-6632
DOI:10.1111/nyas.12034