J Korean Soc Pediatr Nephrol.  2008 Oct;12(2):133-142.

Allograft Immune Reaction of Kidney Transplantation Part 2. Immunosuppression and Methods to Assess Alloimmunity

• Kang HG

Abstract

For solid organ transplant, ABO blood type of donor and recipient should be compatible in principle. Recent improvement of immunosuppressant made HLA typing not so important while no-mismatch transplant still shows the longest graft survival. PRA(panel reactive antibody) test is to screen and identify recipients with HLA sensitization. When solid organ transplant is scheduled, cross-match test of donor cell and recipient serum should be performed and positive result of cross-match prohibits transplantation. Donor specific antibody (DSA) test can predict the severity of recipient immune reaction against donor organ. Today's mainstay of allograft immunosuppressant regimen is triple therapy of steroid, calcineurin inhibitor(cyclosporine, tacrolimus), azathioprine or mycophenolate mofetil(MMF). Antibody induction using Thymoglobulin or anti-IL-2 receptor antibody(basiliximab or daclizumab) is frequently practiced as well.

Keyword

Allograft immunity; Anti-HLA antibody; PRA(panel reactive antibody); Crossmatch; Immunosuppressant

MeSH Terms

Antilymphocyte Serum
Azathioprine
Calcineurin
Graft Survival
Histocompatibility Testing
Humans
Immunosuppression
Kidney
Kidney Transplantation
Tissue Donors
Transplantation, Homologous
Transplants
Antilymphocyte Serum
Azathioprine
Calcineurin