Clinical recommendations for posttransplant assessment of anti–HLA (Human Leukocyte Antigen) donor-specific antibodies: A Sensitization in Transplantation: Assessment of Risk consensus document

STAR 2022 Working Group

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Although anti–HLA (Human Leukocyte Antigen) donor-specific antibodies (DSAs) are commonly measured in clinical practice and their relationship with transplant outcome is well established, clinical recommendations for anti-HLA antibody assessment are sparse. Supported by a careful and critical review of the current literature performed by the Sensitization in Transplantation: Assessment of Risk 2022 working group, this consensus report provides clinical practice recommendations in kidney, heart, lung, and liver transplantation based on expert assessment of quality and strength of evidence. The recommendations address 3 major clinical problems in transplantation and include guidance regarding posttransplant DSA assessment and application to diagnostics, prognostics, and therapeutics: (1) the clinical implications of positive posttransplant DSA detection according to DSA status (ie, preformed or de novo), (2) the relevance of posttransplant DSA assessment for precision diagnosis of antibody-mediated rejection and for treatment management, and (3) the relevance of posttransplant DSA for allograft prognosis and risk stratification. This consensus report also highlights gaps in current knowledge and provides directions for clinical investigations and trials in the future that will further refine the clinical utility of posttransplant DSA assessment, leading to improved transplant management and patient care.

Original languageEnglish
Pages (from-to)115-132
Number of pages18
JournalAmerican Journal of Transplantation
Volume23
Issue number1
DOIs
StatePublished - Jan 2023

Keywords

  • alloantibody
  • biomarker
  • clinical research/practice
  • clinical trial design
  • endotype
  • guidelines
  • histocompatibility
  • immune monitoring
  • immunobiology
  • rejection

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