Anti‐HLA alloantibodies in pediatric solid organ transplantation

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Abstract
Abstract: An increasing number of studies demonstrate the clinical impact of preformed andde novoanti‐human leucocyte antigen alloantibody (HLA‐Ab) in solid organ transplantation (Tx). The screening of HLA‐Ab in candidates and transplant recipients has evolved over time, with continuous improvement in the sensitivity and specificity of assays for HLA‐Ab detection. Furthermore, histologic markers of complement activation pathways are currently implemented in the diagnosis of antibody‐mediated rejection (AMR). Therapeutic strategies, including depletion of HLA‐Ab and B cells, have allowed Tx across antibody barriers, or have rescued patients with AMR. The purpose of the present review is to summarize the state‐of‐the‐art of HLA‐Ab detection, clinical significance and therapeutic strategies in pediatric solid organ Tx.