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Immunology of Kidney Transplantation

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Contemporary Kidney Transplantation

Part of the book series: Organ and Tissue Transplantation ((OTT))

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Abstract

The immunological response against an allograft kidney is a barrier to long-term graft survival. While the basic science of transplant immunology is well understood, the clinical application of this information is lagging. Histocompatibility testing has become the predominant immunological monitoring for allografts and largely focuses on assaying for donor-recipient human leukocyte antigen (HLA) compatibility and measuring circulating anti-HLA antibodies. The identification of HLA antigens and genes has permitted the accurate and comprehensive matching for donors and recipients.

Multiple histocompatibility methods have been developed to examine for the presence of anti-HLA antibodies and best determine donor-recipient suitability. Methods for antibody detection and crossmatching have become more sensitive with the introduction of fluorescent detection modalities compared to older cytotoxic methods. However, the functional characteristics of antibodies may be lost unless further assay enhancements are incorporated, such as complement-fixing antibody tests. Additionally, non-HLA antibodies are now being recognized as also contributing to the outcome of renal transplantation.

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Authors and Affiliations

  1. Histocompatibility Laboratory, Gift of Hope Organ & Tissue Donor Network, Itasca, IL, 60143, USA

    John G. Lunz III

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  1. John G. Lunz III
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Correspondence to John G. Lunz III .

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Editors and Affiliations

  1. Sidney Kimmel Medical College, Thomas Jefferson University Hospital Transplant Surgery, Philadelphia, Pennsylvania, USA

    Carlo Gerardo B. Ramirez

  2. Department of Medicine, Thomas Jefferson University Hospital Division of Nephrology, Philadelphia, Pennsylvania, USA

    Jerry McCauley

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Lunz, J.G. (2017). Immunology of Kidney Transplantation. In: Ramirez, C., McCauley, J. (eds) Contemporary Kidney Transplantation. Organ and Tissue Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-14779-6_17-1

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  • DOI: https://doi.org/10.1007/978-3-319-14779-6_17-1

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