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HLA and ABO sensitization and desensitization in renal transplantation

Christina L Klein, MD
Daniel C Brennan, MD, FACP
Section Editor
Barbara Murphy, MB, BAO, BCh, FRCPI
Deputy Editor
Albert Q Lam, MD


Despite a marked increase in the number of living-donor allografts (LDAs) performed annually, many potential recipients with otherwise suitable donors are relegated to the ever-expanding deceased-donor waiting list secondary to either:

Preformed human leukocyte antigen (HLA) antibodies. These are acquired via pregnancy, transfusion, or prior transplant.


ABO blood group incompatibility (ABOI).

If not adequately removed, the presence of such antibodies is likely to result in severe antibody-mediated rejection (AMR) and early graft loss. AMR or "humoral" rejection was recognized early in the history of transplantation as hyperacute rejection caused by the presence of preformed antibodies ("humors") to donor blood group ABO or HLA. Introduction of pretransplant crossmatch techniques and the use of ABO-compatible donors essentially eliminated hyperacute rejection.

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Literature review current through: Nov 2017. | This topic last updated: Jan 10, 2017.
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