الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Kidney transplantation is the best choice for patients with end stage renal disease.
There has been steady progress in renal allograft survival since the development of
proper HLA matching and sufficient immunosuppressive therapy.
Allograft survival depends on a number of immunologic factors that determine
whether the graft will be rejected or not. These factors include HLA matching
between donor and recipient, the pre-transplantation sensitization status of the
recipient, and the ability of the recipient to recognize and respond to donor antigens.
One or more mismatches in HLA-A, HLA-B, and HLA-DR antigens still reduce
allograft survival significantly. Better HLA matched donor allografts have better
survival.
Antibodies directed against HLA antigens of a given organ donor represent the
dominating reason for hyperacute or acute allograft rejections. In order to select
recipients without donor-specific antibodies, a standard crossmatch procedure, the
complement-dependent cytotoxicity assay, was developed. Enzyme-linked
immunosorbent assay-based techniques have been designed to reliably detect anti-
HLA antibodies in recipients.
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.