Application and interpretation of histocompatibility data in pediatric kidney transplantation

作者：Fernandez Hilda E^*

来源：Current Opinion in Organ Transplantation, 2017, 22(4): 426-432.

DOI：10.1097/MOT.0000000000000425

• allograft outcomes
• histocompatibility
• pediatric kidney transplant

Purpose of review
Advances in technology to assess immunologic risk in solid organ transplant offer an opportunity to optimize the approach to pediatric deceased donor kidney transplant in the setting of a new allocation system in the United States.
Recent findings
Degree of human leukocyte antigen (HLA) mismatch, class II HLA mismatch, unacceptable antigens and donor-specific antibody (DSA) detected by solid-phase assays, and epitope matching pretransplant affect pediatric kidney transplant outcomes. Detection of de novo DSAs (dnDSAs) posttransplant has been associated with increased risk of acute rejection and worse allograft function. Development of dnDSA occurs in recipients with greater epitope mismatching.
Summary
Improved long-term outcomes may be anticipated in pediatric kidney transplant recipients by incorporating extended HLA mismatch information and updating the clinical approach to donor kidney matching using available technology to identify clinically relevant immunologic risk.

• 出版日期2017-8