Nonhuman leukocyte antigen antibodies that have impact in the heart transplant patient

Despite human leukocyte antigen (HLA) matching and monitoring for donor-specific HLA antibodies, antibody-mediated rejection and chronic rejection in the form of allograft vasculopathy and chronic graft dysfunction continue to occur. There has been increasing interest in non-HLA antibodies as mediators of these changes.

In this review, we discuss the recent literature describing the importance of non-HLA antibodies in organ transplantation and summarize the literature evaluating such antibodies in heart transplantation.

Monitoring of non-HLA antibodies requires additional measurement standardization and correlation of specific antibodies with outcomes. However, there is promise that identification with newer immunoproteomic techniques and therapy toward such antibodies may improve long-term graft outcomes and decrease acute rejection and allograft vasculopathy.