Differential immunogenicity of HLA mismatches in clinical transplantation

Although HLA matching is beneficial in clinical transplantation, it is not feasible to select a completely HLA matched donor for every potential recipient because of the enormous polymorphism of the HLA system. As a consequence, the majority of the recipients will be transplanted with a mismatched d...

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Bibliographic Details
Published in:Transplant Immunology 2005-08, Vol.14 (3), p.187-191
Main Authors: Claas, Frans H.J., Dankers, Marlies K., Oudshoorn, Machteld, van Rood, Jon J., Mulder, Arend, Roelen, Dave L., Duquesnoy, Rene J., Doxiadis, Ilias I.N.
Format: Article
Language:English
Subjects:
Algorithms
Animals
Clinical transplantation
Differential immunogenicity
Donor Selection - methods
Graft Survival - genetics
Graft Survival - immunology
Histocompatibility
Histocompatibility Testing - methods
HLA Antigens - genetics
HLA Antigens - immunology
HLA mismatches
Humans
Polymorphism, Genetic
Software
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Summary:Although HLA matching is beneficial in clinical transplantation, it is not feasible to select a completely HLA matched donor for every potential recipient because of the enormous polymorphism of the HLA system. As a consequence, the majority of the recipients will be transplanted with a mismatched donor organ or hematopoietic stem cell transplant. For this large group of patients it is important to take advantage of the differential immunogenicity of HLA mismatches and to select for them a donor with HLA mismatches of low immunogenicity, the so-called acceptable mismatches. The differential immunogenicity of HLA mismatches can be determined by either retrospective analysis of graft survival data or by in vitro assays measuring T-cell and B-cell alloreactivity. A recently developed computer algorithm (HLAMatchmaker) can be instrumental in selecting donors with HLA mismatches, which do not lead to alloantibody formation. The theoretical background and practical implications of this acceptable mismatch approach are discussed.
ISSN:0966-3274
1878-5492
1365-2567
DOI:10.1016/j.trim.2005.03.007