Brian D.Tait, Caner Susal, Howard M.Gebel, Peter W.Nickerson, Andrea A.Zachary, Frans H.J.Claas, Elaine F.Reed, Robert A.Bray, Patricia Campbell, Jeremy R.Chapman, P.Toby Coates, Robert B.Colvin, Emanuele Cozzi, Ilias I.N.Doxiadis, Susan V.Fuggle, John Gill, Denis Glotz, Nils Lachmann, Thalachallour Mohanakumar, Nicole Suciu-Foca, Suchitra Sumitran-Holgersson, Kazunari Tanabe, Craig J.Taylor, Dolly B.Tyan, Angela Webster, Adriana Zeevi, and Gerhard Opelz
Background. The introduction of solid-phase immunoassay (SPI) technology for the detection and characterization of human leukocyte antigen (HLA) antibodies in transplantation while providing greater sensitivity than was obtainable by complement-dependent lymphocytotoxicity (CDC) assays has resulted in a new paradigm with respect to the interpretation of donor-specific antibodies (DSA). Although the SPI assay performed on the Luminex instrument…
Annette M. Jackson, Mary S. Leffell, Robert A. Montgomery, and Andrea A. Zachary
Purpose of review
To identify factors that affect the choice of route to renal transplantation for the sensitized patient. The evolution of protocols for transplanting sensitized patients has been desensitization (DES), paired donation, and most recently, paired donation combined with DES. Use of these protocols has revealed various factors that influence which route is the most likely to work for a given patient.
The data indicate that patient blood type and HLA sensitization have the dominant influence on what route is best for a patient but numerous other factors, particularly the number, HLA type, and ABO type of donors a patient brings to a program will also affect the likelihood of transplantation. The distribution of these factors among patients transplanted or unable…
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