Precision transplant pathology

Transplant pathology contributes substantially to personalized treatment of organ allograft recipients. Rapidly advancing next-generation human leukocyte antigen (HLA) sequencing and pathology are enhancing the abilities to improve donor/recipient matching and allograft monitoring. The present revie...

Full description

Saved in:

Bibliographic Details
Published in:	Current opinion in organ transplantation Vol. 25; no. 4; pp. 412 - 419
Main Authors:	Wood-Trageser, Michelle A., Xu, Qinyong, Zeevi, Adriana, Randhawa, Parmjeet, Lesniak, Drew, Demetris, Anthony J.
Format:	Journal Article
Language:	English
Published:	United States Wolters Kluwer Health, Inc. All rights reserved 01-08-2020
Subjects:	Histocompatibility Testing HLA Antigens - immunology Humans Organ Transplantation - methods Precision Medicine - methods Tissue Donors Transplantation Immunology Transplantation, Homologous Transplants - immunology Transplants - pathology
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Transplant pathology contributes substantially to personalized treatment of organ allograft recipients. Rapidly advancing next-generation human leukocyte antigen (HLA) sequencing and pathology are enhancing the abilities to improve donor/recipient matching and allograft monitoring. The present review summarizes the workflow of a prototypical patient through a pathology practice, highlighting histocompatibility assessment and pathologic review of tissues as areas that are evolving to incorporate next-generation technologies while emphasizing critical needs of the field. Successful organ transplantation starts with the most precise pratical donor-recipient histocompatibility matching. Next-generation sequencing provides the highest resolution donor-recipient matching and enables eplet mismatch scores and more precise monitoring of donor-specific antibodies (DSAs) that may arise after transplant. Multiplex labeling combined with hand-crafted machine learning is transforming traditional histopathology. The combination of traditional blood/body fluid laboratory tests, eplet and DSA analysis, traditional and next-generation histopathology, and -omics-based platforms enables risk stratification and identification of early subclinical molecular-based changes that precede a decline in allograft function. Needs include software integration of data derived from diverse platforms that can render the most accurate assessment of allograft health and needs for immunosuppression adjustments.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-2
ISSN:	1087-2418 1531-7013
DOI:	10.1097/MOT.0000000000000772