Relevance of donor-specific HLA antibodies in hematopoietic cell transplantation

IF 2.2 4区医学 Q3 HEMATOLOGY Best Practice & Research Clinical Haematology Pub Date : 2024-09-01 DOI:10.1016/j.beha.2024.101576

Thuong Hien Tran , Andreas Heinold , Magdalena Spackova , Lien Pham , Matthias Stelljes , Peter Dreger

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Abstract

Advances in hematopoietic cell transplantation have expanded the use of alternative donors such as haploidentical family donors or mismatched unrelated donors. However, donor-specific HLA antibodies (DSA) have been recognized as a significant risk factor of primary graft failure after HLA incompatible transplantation. Therefore, screening for HLA antibodies and taking DSA into consideration in the process of donor search play an increasingly important role in donor selection. If an HLA compatible donor is not available, desensitization may enable a successful transplantation. In this review, we describe the currently most widely used methods for HLA antibody detections including their pitfalls. In addition, we summarize the results of the studies on the impact of preformed DSA on transplant outcomes and their treatment options. Many more and larger studies are needed to clarify laboratory issues as well as immunological and clinical aspects in the management of DSA.

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供体特异性 HLA 抗体与造血细胞移植的相关性

造血细胞移植的进步扩大了替代供体的使用范围，如单倍体家族供体或不匹配的非亲属供体。然而，供者特异性 HLA 抗体（DSA）已被认为是 HLA 不相容移植后导致原发性移植失败的重要风险因素。因此，在寻找供体的过程中，筛查 HLA 抗体和考虑 DSA 在供体选择中发挥着越来越重要的作用。如果无法获得 HLA 相容的供体，脱敏治疗可使移植成功。在这篇综述中，我们介绍了目前最广泛使用的 HLA 抗体检测方法，包括其误区。此外，我们还总结了有关预制 DSA 对移植结果的影响及其治疗方案的研究结果。还需要进行更多更大规模的研究，以澄清 DSA 管理中的实验室问题以及免疫学和临床方面的问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Best Practice & Research Clinical Haematology 医学-血液学

CiteScore

4.20

自引率

0.00%

发文量

审稿时长

35 days

期刊介绍： Best Practice & Research Clinical Haematology publishes review articles integrating the results from the latest original research articles into practical, evidence-based review articles. These articles seek to address the key clinical issues of diagnosis, treatment and patient management. Each issue follows a problem-orientated approach which focuses on the key questions to be addressed, clearly defining what is known and not known, covering the spectrum of clinical and laboratory haematological practice and research. Although most reviews are invited, the Editor welcomes suggestions from potential authors.