Sensitization in Transplantation: Assessment of Risk (STAR) 2017 Working Group Meeting Report Academic Article uri icon

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abstract

  • The presence of preexisting (memory) or de novo donor-specific HLA antibodies (DSAs) is a known barrier to successful long-term organ transplantation. Yet, despite the fact that laboratory tools and our understanding of histocompatibility have advanced significantly in recent years, the criteria to define presence of a DSA and assign a level of risk for a given DSA vary markedly between centers. A collaborative effort between the American Society for Histocompatibility and Immunogenetics and the American Society of Transplantation provided the logistical support for generating a dedicated multidisciplinary working group, which included experts in histocompatibility as well as kidney, liver, heart, and lung transplantation. The goals were to perform a critical review of biologically driven, state-of-the-art, clinical diagnostics literature and to provide clinical practice recommendations based on expert assessment of quality and strength of evidence. The results of the Sensitization in Transplantation: Assessment of Risk (STAR) meeting are summarized here, providing recommendations on the definition and utilization of HLA diagnostic testing, and a framework for clinical assessment of risk for a memory or a primary alloimmune response. The definitions, recommendations, risk framework, and highlighted gaps in knowledge are intended to spur research that will inform the next STAR Working Group meeting in 2019.

authors

  • Tambur, Anat R
  • Campbell, Patricia
  • Claas, Frans H
  • Feng, Sandy
  • Gebel, Howard M
  • Jackson, Annette M
  • Mannon, Roslyn B
  • Reed, Elaine F
  • Tinckam, Kathryn
  • Askar, Medhat
  • Chandraker, Anil
  • Chang, Patricia P
  • Colvin, Monica
  • Demetris, Anthony-Jake
  • Diamond, Joshua M
  • Dipchand, Anne I
  • Fairchild, Robert L
  • Ford, Mandy L
  • Friedewald, John
  • Gill, Ronald G
  • Glotz, Denis
  • Goldberg, Hilary
  • Hachem, Ramsey
  • Knechtle, Stuart
  • Kobashigawa, Jon
  • Levine, Deborah J
  • Levitsky, Joshua
  • Mengel, Michael
  • Milford, Edgar
  • Newell, Kenneth A
  • O’Leary, Jacqueline G
  • Palmer, Scott
  • Randhawa, Parmjeet
  • Smith, James
  • Snyder, Laurie
  • Starling, Randall C
  • Sweet, Stuart
  • Taner, Timucin
  • Taylor, Craig J
  • Woodle, Steve
  • Zeevi, Adriana
  • Nickerson, Peter

publication date

  • July 2018