Donor-Specific Antibody Monitoring: Where Is the Beef?

Document Type

Article

Publication Date

9-1-2016

Publication Title

Advances in chronic kidney disease

Abstract

This review paper discusses the impact of de novo donor-specific antibodies (DSA) to donor HLA antigens in kidney transplantation and summarizes the benefits and challenges that exist with DSA monitoring. Post-transplant DSA is associated with worse allograft outcomes and its detection may precede or coincide with clinical, biochemical, and histologic allograft dysfunction. There are no absolute features of DSA testing results that perfectly discriminate between states of disease and health. In a state of antibody-associated graft dysfunction, removal or reduction in DSA may only provide clinical benefit for some. Furthermore, various factors influence test results, and detection of HLA antibodies must be interpreted within the appropriate clinical and laboratory context. The utility of DSA monitoring is further affected by the limited effectiveness of treatment for antibody-mediated rejection. Although DSA monitoring is potentially beneficial in some circumstances, the optimal screening and treatment strategies are still to be defined.

Medical Subject Headings

Autoantibodies; Graft Rejection; Graft Survival; HLA Antigens; Humans; Kidney Transplantation; Tissue Donors

PubMed ID

27742387

Volume

23

Issue

5

First Page

317

Last Page

325

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