Abstract
The role of anti-HLA antibodies in solid organ rejection is well established and these antibodies are routinely monitored both in patients in the waiting list and in the post-transplant setting. More recently, the presence of other antibodies directed towards non-HLA antigens, or the so-called minor histocompatibility antigens, has drawn the attention of the transplant community; however, their possible involvement in the graft outcome remains uncertain. These antibodies have been described to possibly have a role in rejection and allograft failure. This review focuses on the most studied non-HLA antibodies and their association with different clinical outcomes considered in solid organ transplantation with the aim of clarifying their clinical implication and potential relevance for routine testing.
Highlights
The Major Histocompatibility Complex (MHC) was such named after initial experiments with allograft compatibility in mice
Such antigens have been called non-Human Leukocyte Antigen (HLA) or Minor Histocompatibility antigens. These new actors have been less studied than HLA and anti-HLA Abs. The interest in this area has notably increased in recent years, and testing for Abs targeting non-HLA antigens is suggested in cases of antibody mediated rejection (ABMR) with no detectable donor-specific anti-HLA Abs (DSA) [4,5]
This study showed that the presence of these Abs together with anti-HLA Abs was significantly associated with a decreased global allograft survival
Summary
The Major Histocompatibility Complex (MHC) was such named after initial experiments with allograft compatibility in mice. Poor graft outcomes are reported in matched-HLA lung recipients [3] These findings suggest that other antigen determinants might be implicated in allograft rejection. Such antigens have been called non-HLA or Minor Histocompatibility antigens. These new actors have been less studied than HLA and anti-HLA Abs. the interest in this area has notably increased in recent years, and testing for Abs targeting non-HLA antigens is suggested in cases of antibody mediated rejection (ABMR) with no detectable donor-specific anti-HLA Abs (DSA) [4,5]. The present work provides updated information about the clinical implication of non-HLA antibodies in different solid-organ transplantations and their relevance in routine testing
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