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

• Type of Material: Article
• Authors: Anat R. Tambur, Northwestern University; Patricia Campbell, University of Alberta; Anita S. Chong, University of Chicago; Sandy Feng, University of California San Francisco; Mandy Ford, Emory University; Howard Gebel, Emory University; Ronald G. Gill, University of Colorado; Garnett Kelsoe, Duke University; Vasilis Kosmoliaptsis, University of Cambridge; Roslyn B. Mannon, University of Alabama Birmingham; Michael Mengel, University of Alberta; Elaine F. Reed, University of California Los Angeles; Nicole M. Valenzuela, University of California Los Angeles; Chris Wiebe, University of Manitoba; I. Esme Dijke, University of Alberta; Harold Sullivan, Emory University; Peter Nickerson, University of Manitoba
• Language: English
• Date: 2020-05-27
• Publisher: WILEY
• Publication Version: Final Published Version
• Copyright Statement: © 2020 The Authors. American Journal of Transplantation published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1111/ajt.15937
• Title of Journal or Parent Work: AMERICAN JOURNAL OF TRANSPLANTATION
• Volume: 20
• Issue: 10
• Start Page: 2652
• End Page: 2668
• Grant/Funding Information: This study was sponsored by the National Institute of Allergy and Infectious Diseases, American Society of Histocompatibility and Immunogenetics, American Society of Transplantation, and Paul Terasaki Research Fund.
• Keywords: lymphocyte biology; Life Sciences & Biomedicine; SINGLE-NUCLEOTIDE POLYMORPHISMS; antibody-mediated (ABMR); MEMORY B-CELLS; Surgery; T-CELLS; KIDNEY-TRANSPLANTATION; rejection; alloantibody; clinical research; major histocompatibility complex (MHC); ENDOTHELIAL-CELLS; practice; antigen biology; Transplantation; IMMUNOLOGICAL MEMORY; ANTI-HLA ANTIBODIES; PRETRANSPLANT FREQUENCY; BELATACEPT-RESISTANT REJECTION; GRAFT LOSS; Science & Technology; histocompatibility
• Research Categories: Health Sciences, Immunology; Health Sciences, Medicine and Surgery

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.