The long and winding road towards epitope matching in clinical transplantation

被引：34
|
作者：
Kramer, Cynthia S. M. [1 ]
Israeli, Moshe [2 ]
Mulder, Arend [1 ]
Doxiadis, Ilias I. N. [3 ]
Haasnoot, Geert W. [1 ]
Heidt, Sebastiaan [1 ]
Claas, Frans H. J. [1 ]
机构：
[1] Leiden Univ, Med Ctr, Dept Immunohaematol & Blood Transfus, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands
[2] Rabin Med Ctr, Tissue Typing Lab, Petah Tiqwa, Israel
[3] Univ Klinikum Leipzig, Inst Transfus Med, Leipzig, Germany
来源：
TRANSPLANT INTERNATIONAL | 2019年 / 32卷 / 01期
关键词：
antibodies; epitopes; HLA matching; immunogenicity; virtual crossmatch; HUMAN-LEUKOCYTE ANTIGEN; HLA CLASS-I; HIGH-RESOLUTION; DONOR; ANTIBODIES; IMMUNOGENICITY; BINDING; REACTIVITY; WEBSITE;
D O I：
10.1111/tri.13362
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
Recent data suggest that HLA epitope matching is beneficial for the prevention of de novo donor specific antibody (DSA) formation after transplantation. In this review, different approaches to predict the immunogenicity of an HLA mismatch will be discussed. The parameters used in these models are often called epitopes but the actual antibody epitope is far more complex. Exact knowledge of the antibody epitope is crucial if epitope matching is also used as a tool to select compatible donors for (highly) sensitized patients. Evidence is provided that it is not always possible to give an exact definition of an antibody epitope. We conclude that HLA "epitope" matching is superior over HLA antigen matching with respect to the prevention of de novo DSA formation and will enhance the prediction of acceptable HLA mismatches for sensitized patients. However, epitope matching at our current level of knowledge will not solve all histocompatibility problems as unexpected antibody reactivity still may occur.
引用
收藏
页码：16 / 24
页数：9
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