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Immunological considerations—HLA matching and management of high immunological risk recipients

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Lung transplant outcomes remain inferior largely due to mismatching in human leukocyte antigens (HLAs) that leads to chronic rejection and chronic allograft dysfunction. The mismatched donor HLAs can be recognized by the effector T cells or donor-specific HLA antibodies. This review summarizes mechanisms leading to immune responses as a result of HLA mismatching. It specifically focuses on sensitized lung transplant candidates with preformed anti-HLA antibodies, which represent a significant management challenge for physicians. In this review, we describe the diagnostic histocompatibility testing and therapeutic options for managing the sensitized lung transplant patients and discuss how multidisciplinary approach may help to improve lung transplantation outcomes.

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Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, MedStar Georgetown University Hospital, Washington D. C., USA

    Olga Timofeeva

  2. Department of Thoracic Medicine, Temple University Hospital, Philadelphia, USA

    James Brown

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  1. Olga Timofeeva
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Correspondence to Olga Timofeeva or James Brown.

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Timofeeva, O., Brown, J. Immunological considerations—HLA matching and management of high immunological risk recipients. Indian J Thorac Cardiovasc Surg 38 (Suppl 2), 248–259 (2022). https://doi.org/10.1007/s12055-021-01201-5

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