Sensitization in transplantation: Assessment of risk (STAR) 2019 Working Group Meeting Report.


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Article
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Abstract

The purpose of the STAR 2019 Working Group was to build on findings from the initial STAR report to further clarify the expectations, limitations, perceptions, and utility of alloimmune assays that are currently in use or in development for risk assessment in the setting of organ transplantation. The goal was to determine the precision and clinical feasibility/utility of such assays in evaluating both memory and primary alloimmune risks. The process included a critical review of biologically driven, state-of-the-art, clinical diagnostics literature by experts in the field and an open public forum in a face-to-face meeting to promote broader engagement of the American Society of Transplantation and American Society of Histocompatibility and Immunogenetics membership. This report summarizes the literature review and the workshop discussions. Specifically, it highlights (1) available assays to evaluate the attributes of HLA antibodies and their utility both as clinical diagnostics and as research tools to evaluate the effector mechanisms driving rejection; (2) potential assays to assess the presence of alloimmune T and B cell memory; and (3) progress in the development of HLA molecular mismatch computational scores as a potential prognostic biomarker for primary alloimmunity and its application in research trial design.

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Keywords
alloantibody, antigen biology, clinical research/practice, histocompatibility, lymphocyte biology, major histocompatibility complex (MHC), rejection: antibody-mediated (ABMR), Graft Rejection, Group Processes, HLA Antigens, Histocompatibility, Isoantibodies, Kidney Transplantation
Journal Title
Am J Transplant
Conference Name
Journal ISSN
1600-6135
1600-6143
Volume Title
20
Publisher
Elsevier BV