Donor-Specific HLA Antibodies as Biomarkers of Transplant Rejection

Olga A Timofeeva

doi:10.1016/j.cll.2018.10.007

Donor-Specific HLA Antibodies as Biomarkers of Transplant Rejection

Clin Lab Med. 2019 Mar;39(1):45-60. doi: 10.1016/j.cll.2018.10.007. Epub 2018 Dec 18.

Author

Olga A Timofeeva¹

Affiliation

¹ Pathology and Laboratory Medicine, Temple University and Hospital, Lewis Katz School of Medicine, 3401 North Broad Street, Room A2-F388, Philadelphia, PA 19140, USA. Electronic address: olga.timofeeva@tuhs.temple.edu.

PMID: 30709508
DOI: 10.1016/j.cll.2018.10.007

Abstract

This article reviews the current evidence to classify donor-specific antibodies (DSAs) using Food and Drug Administration-National Institutes of Health Biomarkers, EndpointS, and other Tools (BEST) resource terms as diagnostic, prognostic, predictive, monitoring, and risk biomarkers for graft rejection. The emphasis is on DSA characteristics, including the DSA levels determined by mean fluorescence intensity and/or titers, the ability to activate a complement cascade (C1q, C3d, and C4d binding), and specific IgG subclasses to define distinct roles of DSAs as biomarkers in clinical practice. In addition, technical limitation of DSA testing is discussed.

Keywords: Biomarker; C1q; Donor-specific antibody; IgG subclass; Rejection; Titer.

Publication types

Review

MeSH terms

Antibodies / blood
Biomarkers / blood
Graft Rejection / diagnosis
Graft Rejection / immunology*
HLA Antigens / immunology*
Humans
Tissue and Organ Procurement*

Substances

Antibodies
Biomarkers
HLA Antigens