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Journal of Immunology Research
Volume 2017 (2017), Article ID 5619402, 7 pages
https://doi.org/10.1155/2017/5619402
Review Article

Clinical Relevance of HLA Antibodies in Kidney Transplantation: Recent Data from the Heidelberg Transplant Center and the Collaborative Transplant Study

1Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
2Department of Pediatrics I, University Children’s Hospital, University of Heidelberg, Heidelberg, Germany
3Department of Transplantation and General Surgery, University of Heidelberg, Heidelberg, Germany
4Division of Nephrology, University of Heidelberg, Heidelberg, Germany

Correspondence should be addressed to Caner Süsal

Received 23 December 2016; Revised 2 March 2017; Accepted 8 March 2017; Published 4 June 2017

Academic Editor: Senthami R. Selvan

Copyright © 2017 Caner Süsal et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Herein, we summarize our recent findings from the international Collaborative Transplant Study (CTS) and Heidelberg Transplant Center regarding the role of HLA antibodies in kidney transplantation and their application into the clinical routine. Based on the antibody findings from the CTS serum study, an algorithm was developed in 2006 for the transplantation of high-risk sensitized patients at the Heidelberg Transplant Center which includes seven different pre- and posttransplant measures. Using this algorithm, the number of transplantations could be increased in high-risk presensitized patients and the previously existing impact of antibodies on graft survival could greatly be diminished but not totally eliminated. More recent findings led to the hypothesis that T cell help from a preactivated immune system supports the harmful effects of pretransplant donor-specific HLA antibodies that otherwise disappear in many cases after transplantation without any consequence.