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Published ahead of print on January 25, 2006
Clin J Am Soc Nephrol 1: 433-440, 2006
© 2006 American Society of Nephrology
doi: 10.2215/CJN.01751105

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Moving Points in Nephrology

Sensitization after Kidney Transplantation

Enver Akalin*, and Manuel Pascual{dagger}

* Renal Division and Recanati/Miller Transplantation Institute, Mount Sinai Medical School, New York, New York; and {dagger} Transplantation Center, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

Address correspondence to: Dr. Enver Akalin, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1104, New York, NY 10029. Phone: 212-659-8003; Fax: 212-348-2474 E-mail: enver.akalin{at}msnyuhealth.org

Kidney transplant recipients may develop de novo anti-HLA and non-HLA antibodies after transplantation. Although these antibodies may be donor-specific or non–donor-specific, their presence may increase the risk for acute and chronic rejection, thereby decreasing allograft survival. The introduction of more sensitive and specific methods to detect anti-HLA antibodies, such as Flow Specific Beads and FlowPRA, both before and after transplantation, will help to define immunologically high-risk kidney transplant recipients. Thus, posttransplantation monitoring of anti-HLA antibody production will allow the identification of kidney transplant recipients who might be at increased risk for late allograft failure. Moreover, knowledge of alloantibody status after transplantation may help to guide the appropriate use of immunomodulatory agents to downregulate anti-HLA antibody production.




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