Abstract：
Although anti-HLA (Human Leukocyte Antigen) donor-specific antibodies (DSAs) are commonly measured in clinical practice and their relationship with transplant outcome is well established, clinical recommendations for anti-HLA antibody assessment are sparse. Supported by a careful and critical review of the current literature performed by the Sensitization in Transplantation: Assessment of Risk 2022 working group, this consensus report provides clinical practice recommendations in kidney, heart, lung, and liver transplantation based on expert assessment of quality and strength of evidence. The recommendations address 3 major clinical problems in transplantation and include guidance regarding posttransplant DSA assessment and application to diagnostics, prognostics, and therapeutics: (1) the clinical implications of positive posttransplant DSA detection according to DSA status (ie, preformed or de novo), (2) the relevance of posttransplant DSA assessment for precision diagnosis of antibody-mediated rejection and for treatment management, and (3) the relevance of posttransplant DSA for allograft prognosis and risk stratification. This consensus report also highlights gaps in current knowledge and provides directions for clinical investigations and trials in the future that will further refine the clinical utility of posttransplant DSA assessment, leading to improved transplant management and patient care.
摘要：
尽管抗HLA（人白细胞抗原）供体特异性抗体（DSA）在临床实践中通常被测量，并且它们与移植结果的关系已被确定。抗HLA抗体评估的临床建议很少.在对移植中的敏感性：2022年风险评估工作组进行的对当前文献的仔细和批判性审查的支持下，这份共识报告提供了肾脏的临床实践建议，心,肺，和肝移植基于专家对质量和证据强度的评估。这些建议解决了移植中的3个主要临床问题，包括有关移植后DSA评估和诊断应用的指导。预测,和治疗：（1）根据DSA状态进行阳性移植后DSA检测的临床意义（即，预制或从头)，（2）移植后DSA评估对抗体介导的排斥反应的精确诊断和治疗管理的相关性，（3）移植后DSA与同种异体移植预后和危险分层的相关性。这份共识报告还强调了当前知识的差距，并为将来的临床研究和试验提供了方向，这将进一步完善移植后DSA评估的临床实用性。改善移植管理和患者护理。
