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Blood Sep 2019Allogeneic hematopoietic cell transplantation involves consideration of both donor and recipient characteristics to guide the selection of a suitable graft. Sufficient... (Review)
Review
Allogeneic hematopoietic cell transplantation involves consideration of both donor and recipient characteristics to guide the selection of a suitable graft. Sufficient high-resolution donor-recipient HLA match is of primary importance in transplantation with adult unrelated donors, using conventional graft-versus-host disease prophylaxis. In cord blood transplantation, optimal unit selection requires consideration of unit quality, cell dose and HLA-match. In this summary, the National Marrow Donor Program (NMDP) and the Center for International Blood and Marrow Transplant Research, jointly with the NMDP Histocompatibility Advisory Group, provide evidence-based guidelines for optimal selection of unrelated donors and cord blood units.
Topics: Adult; Cord Blood Stem Cell Transplantation; Donor Selection; Fetal Blood; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Histocompatibility Testing; Humans; Infant, Newborn; Registries; Unrelated Donors
PubMed: 31292117
DOI: 10.1182/blood.2019001212 -
Transplant International : Official... 2023Imlifidase recently received early access authorization for highly sensitized adult kidney transplant candidates with a positive crossmatch against an ABO-compatible...
Imlifidase recently received early access authorization for highly sensitized adult kidney transplant candidates with a positive crossmatch against an ABO-compatible deceased donor. These French consensus guidelines have been generated by an expert working group, in order to homogenize patient selection, associated treatments and follow-up. This initiative is part of an international effort to analyze properly the benefits and tolerance of this new costly treatment in real-life. Eligible patients must meet the following screening criteria: cPRA ≥ 98%, ≤ 65-year of age, ≥ 3 years on the waiting list, and a low risk of biopsy-related complications. The final decision to use Imlifidase will be based on the two following criteria. First, the results of a virtual crossmatch on recent serum, which shall show a MFI for the immunodominant donor-specific antibodies (DSA) > 6,000 but the value of which does not exceed 5,000 after 1:10 dilution. Second, the post-Imlifidase complement-dependent cytotoxicity crossmatch must be negative. Patients treated with Imlifidase will receive an immunosuppressive regimen based on steroids, rATG, high dose IVIg, rituximab, tacrolimus and mycophenolic acid. Frequent post-transplant testing for DSA and systematic surveillance kidney biopsies are highly recommended to monitor post-transplant DSA rebound and subclinical rejection.
Topics: Adult; Humans; Child, Preschool; Kidney Transplantation; Histocompatibility Testing; HLA Antigens; Graft Rejection; Immunosuppressive Agents; Antibodies; Isoantibodies
PubMed: 37448448
DOI: 10.3389/ti.2023.11244 -
Transplant Immunology Aug 2021Xenotransplantation, using genetically-modified pigs for clinical organ transplantation, is a solution to the organ shortage. The biggest barrier to clinical... (Review)
Review
Xenotransplantation, using genetically-modified pigs for clinical organ transplantation, is a solution to the organ shortage. The biggest barrier to clinical implementation is the antigenicity of pig cells. Humans possess preformed antibody to pig cells that initiate antibody-mediated rejection of pig organs in primates. Advances in genetic engineering have led to the development of a pig lacking the three known glycan xenoantigens (triple-knockout [TKO] pigs). A significant number of human sera demonstrate no antibody binding to TKO pig cells. As a result of the TKO pig's low antigen expression, survival of life-supporting pig organs in immunosuppressed nonhuman primates has significantly increased, and hope has been renewed for clinical trials of xenotransplantation. It is important to understand the context in which xenotransplantation's predecessor, allotransplantation, has been successful, and the steps needed for the success of xenotransplantation. Successful allotransplantation has been based on two main immunological approaches - (i) adequate immunosuppressive therapy, and (ii) careful histocompatibility matching. In vivo studies suggest that the available immunosuppressive regimens are adequate to suppress the human anti-pig cellular response. Methods to evaluate and screen patients for the first clinical xenotransplantation trial are the next challenge. The goal of this review is to summarize the history of histocompatibility testing, and the available tools that can be utilized to determine xenograft histocompatibility.
Topics: Animals; Animals, Genetically Modified; Antibodies, Heterophile; Antigens, Heterophile; Cells, Cultured; Gene Knockout Techniques; HLA Antigens; Histocompatibility; Histocompatibility Antigens Class I; Histocompatibility Testing; Humans; Polysaccharides; Swine; Tissue and Organ Procurement; Transplantation, Heterologous
PubMed: 34015463
DOI: 10.1016/j.trim.2021.101409 -
Acta Ophthalmologica Scandinavica Feb 2004
Topics: Corneal Transplantation; Denmark; Histocompatibility; Histocompatibility Antigens; Histocompatibility Testing; Humans; Major Histocompatibility Complex
PubMed: 14738482
DOI: 10.1111/j.1395-3907.2004.00221.x -
American Journal of Transplantation :... Sep 2022
Topics: Graft Rejection; Histocompatibility; Histocompatibility Antigens; Histocompatibility Antigens Class I; Histocompatibility Testing
PubMed: 36039544
DOI: 10.1111/ajt.16672 -
Cancer Control : Journal of the Moffitt... Jan 2015The human leukocyte antigen (HLA) system plays a crucial role in immune function, and HLA testing is often needed in the support of patients with cancer. (Review)
Review
BACKGROUND
The human leukocyte antigen (HLA) system plays a crucial role in immune function, and HLA testing is often needed in the support of patients with cancer.
METHODS
We briefly review the published literature to clarify the nomenclature of the HLA system, currently available methods for HLA testing, and commonly used HLA assays. The uses of HLA testing in pharmacogenomics, disease association, platelet transfusion support, and in the management of both solid organ and hematopoietic stem cell transplantation are also reviewed.
RESULTS
HLA testing is commonly performed for select patient populations, including patients with cancer and in those requiring solid organ and hematopoietic stem cell transplantation.
CONCLUSION
Newer molecular typing methods have helped improve patient outcomes following hematopoietic stem cell transplantation.
Topics: HLA Antigens; Hematopoietic Stem Cell Transplantation; Histocompatibility Testing; Humans; Neoplasms; Organ Transplantation; Platelet Transfusion
PubMed: 25504281
DOI: 10.1177/107327481502200110 -
American Journal of Transplantation :... Jan 2023The Sensitization in Transplantation: Assessment of Risk workgroup is a collaborative effort of the American Society of Transplantation and the American Society of...
The Sensitization in Transplantation: Assessment of Risk workgroup is a collaborative effort of the American Society of Transplantation and the American Society of Histocompatibility and Immunogenetics that aims at providing recommendations for clinical testing, highlights gaps in current knowledge, and proposes areas for further research to enhance histocompatibility testing in support of solid organ transplantation. This report provides updates on topics discussed by the previous Sensitization in Transplantation: Assessment of Risk working groups and introduces 2 areas of exploration: non-human leukocyte antigen antibodies and utilization of human leukocyte antigen antibody testing measurement to evaluate the efficacy of antibody-removal therapies.
Topics: Organ Transplantation; Risk Factors; Histocompatibility; Histocompatibility Testing; Group Processes; Graft Rejection; Isoantibodies
PubMed: 36695615
DOI: 10.1016/j.ajt.2022.11.009 -
American Journal of Hematology Apr 2015Anti-human leukocyte antigens (HLA) antibodies can adversely impact the care of hematology patients. In particular, HLA antibody testing provides important information... (Review)
Review
Anti-human leukocyte antigens (HLA) antibodies can adversely impact the care of hematology patients. In particular, HLA antibody testing provides important information for optimal stem cell and platelet donor selection in the management of stem cell recipients and platelet refractory patients. Current testing methods for HLA antibodies are briefly reviewed, with particular emphasis on laboratory and clinical issues associated with solid-phase multiplex assays.
Topics: Antibody Specificity; Enzyme-Linked Immunosorbent Assay; Flow Cytometry; HLA Antigens; Hematologic Diseases; Hematopoietic Stem Cell Transplantation; Histocompatibility Testing; Humans; Isoantibodies
PubMed: 25580568
DOI: 10.1002/ajh.23935 -
Romanian Journal of Internal Medicine =... 2016From an oncological perspective, the second most common malignancies in children are brain tumors. Despite the recent therapeutic breakthroughs in this field, concerning... (Review)
Review
From an oncological perspective, the second most common malignancies in children are brain tumors. Despite the recent therapeutic breakthroughs in this field, concerning surgery, radiotherapy and chemotherapy alike, some cases still have poor outcomes in curability. This is especially the case in patients with high-risk histological types of tumors, and those suffering from residual, remitting and disseminated diseases. Due to the unique neuroanatomical emplacement of brain tumors and their aggressive infiltrative behavior, their total removal remains a demanding task. This can be perceived in the high rates of failure treatment and disease recurrence. Furthermore, the adjacent healthy brain tissue is inevitably damaged in the surgical process of effectively removing these tumors. Thus, stem cell transplantation may be a viable solution for the clinical management of these malignancies, as proven by various recent breakthroughs. In the current concise review, we present the role of next generation sequencing in HLA typing for stem cell transplantation in primary CNS pediatric malignancies.
Topics: Alleles; Brain Neoplasms; Child; Evidence-Based Medicine; Genotype; Histocompatibility Testing; Humans; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Stem Cell Transplantation; Treatment Outcome
PubMed: 27352438
DOI: 10.1515/rjim-2016-0019 -
HLA Dec 2019The virtual crossmatch (VXM) is gaining acceptance as an alternative approach to assess donor:recipient compatibility prior to transplantation. In contrast to a physical... (Review)
Review
The virtual crossmatch (VXM) is gaining acceptance as an alternative approach to assess donor:recipient compatibility prior to transplantation. In contrast to a physical crossmatch, the virtual crossmatch does not require viable donor cells but rather relies on complete HLA typing of the donor and current antibody assessment of the recipient. Thus, the VXM can be performed in minutes which allows for faster transplant decisions thereby increasing the likelihood that organs can be shipped across significant distances yet safely transplanted. Here, we present a brief review of the past 50 years of histocompatibility testing; from the original complement-dependent cytotoxicity crossmatch in 1969 to the new era of molecular HLA typing, solid-phase antibody testing and virtual crossmatching. These advancements have shaped a paradigm shift in our approach to transplantation. That is, foregoing a prospective physical crossmatch in favor of a VXM. In this review, we undertake an in-depth analysis of the pros- and cons- of physical and virtual crossmatching.Finally, we provide objective data on the selected use of the VXM which demonstrate the value of a VXM in lieu of the traditional physical crossmatch for safe and efficient organ transplantation.
Topics: Blood Grouping and Crossmatching; Clinical Laboratory Techniques; Computational Biology; Histocompatibility Testing; History, 20th Century; History, 21st Century; Humans; Inventions; Patient Selection; Predictive Value of Tests; User-Computer Interface
PubMed: 31515937
DOI: 10.1111/tan.13693