TY  - JOUR
A1  - Ziemann, Malte
A1  - Suwelack, Barbara
A1  - Banas, Bernhard
A1  - Einecke, Gunilla
A1  - Hauser, Ingeborg A.
A1  - Heinemann, Falko
A1  - Kauke, Teresa
A1  - Kelsch, Reinhard
A1  - Koch, Martina
A1  - Lachmann, Nils
A1  - Reuter, Stefan
A1  - Seidl, Christian
A1  - Sester, Urban
A1  - Zecher, Daniel
A1  - Budde, Klemens
T1  - Determination of unacceptable HLA antigen mismatches in kidney transplant recipients
T2  - HLA
N2  - With the introduction of the virtual allocation crossmatch in the Eurotransplant (ET) region in 2023, the determination of unacceptable antigen mismatches (UAM) in kidney transplant recipients is of utmost importance for histocompatibility laboratories and transplant centers. Therefore, a joined working group of members from the German Society for Immunogenetics (Deutsche Gesellschaft für Immungenetik, DGI) and the German Transplantation Society (Deutsche Transplantationsgesellschaft, DTG) revised and updated the previous recommendations from 2015 in light of recently published evidence. Like in the previous version, a wide range of topics is covered from technical issues to clinical risk factors. This review summarizes the evidence about the prognostic value of contemporary methods for HLA antibody detection and identification, as well as the impact of UAM on waiting time, on which these recommendations are based. As no clear criteria could be determined to differentiate potentially harmful from harmless HLA antibodies, the general recommendation is to assign all HLA against which plausible antibodies are found as UAM. There is, however, a need for individualized solutions for highly immunized patients. These revised recommendations provide a list of aspects that need to be considered when assigning UAM to enable a fair and comprehensible procedure and to harmonize risk stratification prior to kidney transplantation between transplant centers.
KW  - HLA antibodies
KW  - immunological risk
KW  - kidney transplantation
KW  - unacceptable antigen mismatches
KW  - waiting time
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/63991
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-639911
SN  - 2059-2310
N1  - Open access funding enabled and organized by Projekt DEAL.
VL  - 100
IS  - 1
SP  - 3
EP  - 17
PB  - Wiley
CY  - Oxford
ER  -