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Chapter 115 : Non-Human Leukocyte Antigen Antibodies in Organ Transplantation
Transplantation can significantly extend the life of patients with end-stage renal disease and provide a lifesaving treatment for patients with failure of other major organs. Extending the long-term survival of these transplanted organs requires a better understanding of the mechanisms of immune injury, including humoral immunity. Alloantibodies were determined early on to be a contraindication to transplantation, but until recently the primary focus has been on HLA-specific antibodies (1). Historically, the lymphocyte crossmatch was the primary tool used to detect HLA antibodies in the sera of transplant recipients and to assess the risk of antibody-mediated rejection posttransplantation. Now, with the advent of solid-phase immunoassays, we can detect HLA antibodies at very low levels and provide a more accurate characterization of their antigen specificities (2).