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HLA Population Genetics in Solid Organ Transplantation.
- Source :
-
Transplantation [Transplantation] 2017 Sep; Vol. 101 (9), pp. 1971-1976. - Publication Year :
- 2017
-
Abstract
- HLAs are fundamental to the adaptive immune response and play critical roles in the cellular and humoral response in solid organ transplantation. The genes encoding HLA proteins are the most polymorphic within the human genome, with thousands of different allelic variants known within the population. Application of the principles of population genetics to the HLA genes has resulted in the development of a numeric metric, the calculated panel-reactive antibody (CPRA) that predicts the likelihood of a positive crossmatch as a function of a transplant candidate's unacceptable HLA antigens. The CPRA is an indispensible measure of access to transplantation for sensitized candidates and is used as the official measure of sensitization for allocation of points in the US Kidney Allocation System and Eurotransplant. Here, we review HLA population genetics and detail the mathematical basis of the CPRA. An understanding of these principles by transplant clinicians will lay the foundation for continued innovation in the care of sensitized patients.
- Subjects :
- Graft Rejection immunology
Graft Rejection prevention & control
Graft Survival
HLA Antigens immunology
Humans
Isoantibodies immunology
Models, Genetic
Organ Transplantation adverse effects
Risk Factors
Treatment Outcome
Genetics, Population
Graft Rejection genetics
HLA Antigens genetics
Histocompatibility
Organ Transplantation methods
Polymorphism, Genetic
Subjects
Details
- Language :
- English
- ISSN :
- 1534-6080
- Volume :
- 101
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 28832450
- Full Text :
- https://doi.org/10.1097/TP.0000000000001830