The Clinical Utility of Post-Transplant Monitoring of Donor-Specific Antibodies in Stable Renal Transplant Recipients: A Consensus Report With Guideline Statements for Clinical Practice.
The Clinical Utility of Post-Transplant Monitoring of Donor-Specific Antibodies in Stable Renal Transplant Recipients: A Consensus Report With Guideline Statements for Clinical Practice.
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DOI：
10.3389/ti.2023.11321
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发表时间：
2023
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影响因子：
--
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中科院分区：
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固相免疫分析改进了供体特异性抗体（DSA）对人白细胞抗原（HLA）抗原特异性的检测和测定。SPI在肾移植中的广泛应用也带来了新的临床难题，例如患者是否应该在移植前或移植后监测DSA。通过SPI进行移植前筛查已成为标准做法，在怀疑排斥的情况下，DSA很容易确定。然而，对于移植物功能稳定的受者，DSA监测尚未被普遍确立为标准护理。这可能与DSA监测作为筛查工具的临床应用的不确定性有关。本共识报告旨在评估无明显移植物功能障碍征象的受者DSA监测的临床应用，使用Wilson & Junger标准评估筛查实践的有效性。为了评估DSA监测的证据，欧洲器官移植学会（ESOT）召集了一个由移植肾病学和免疫学专家组成的专门工作组，审查相关文献。指导方针和声明是在2022年11月在布拉格亲自举行的德尔福方法共识会议上制定的。本文介绍了亚临床DSA监测工作组的研究结果和建议。
Solid phase immunoassays improved the detection and determination of the antigen-specificity of donor-specific antibodies (DSA) to human leukocyte antigens (HLA). The widespread use of SPI in kidney transplantation also introduced new clinical dilemmas, such as whether patients should be monitored for DSA pre- or post-transplantation. Pretransplant screening through SPI has become standard practice and DSA are readily determined in case of suspected rejection. However, DSA monitoring in recipients with stable graft function has not been universally established as standard of care. This may be related to uncertainty regarding the clinical utility of DSA monitoring as a screening tool. This consensus report aims to appraise the clinical utility of DSA monitoring in recipients without overt signs of graft dysfunction, using the Wilson & Junger criteria for assessing the validity of a screening practice. To assess the evidence on DSA monitoring, the European Society for Organ Transplantation (ESOT) convened a dedicated workgroup, comprised of experts in transplantation nephrology and immunology, to review relevant literature. Guidelines and statements were developed during a consensus conference by Delphi methodology that took place in person in November 2022 in Prague. The findings and recommendations of the workgroup on subclinical DSA monitoring are presented in this article.
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影响因子：
6.2
作者：
Chemouny, Jonathan-Maurice;Suberbielle, Caroline;Anglicheau, Dany
通讯作者：
Anglicheau, Dany
影响因子：
3.4
作者：
Waldecker CB;Zgoura P;Seibert FS;Gall S;Schenker P;Bauer F;Rohn B;Viebahn R;Babel N;Westhoff TH
通讯作者：
Westhoff TH
影响因子：
8.8
作者：
Adebiyi, O. O.;Gralla, J.;Cooper, J. E.
通讯作者：
Cooper, J. E.
影响因子：
19.6
作者：
Coemans, Maarten;Suesal, Caner;Naesens, Maarten
通讯作者：
Naesens, Maarten
影响因子：
13.6
作者：
Aubert, Olivier;Loupy, Alexandre;Halloran, Philip F.
通讯作者：
Halloran, Philip F.