Literature Review: The Role of Non-HLA Antibody in Renal Transplantation

Antibodies directed to mismatched donor human leucocyte antigen (HLA-DSA) play a well-established role in antibody mediated rejection (AMR) and graft failure in kidney transplantation, with their presence being correlated with poorer transplant outcomes. The diagnosis of AMR is based on three criteria: Histologic evidence of acute tissue injury, evidence of current/recent antibody interaction with the donor endothelium and serologic evidence of circulating donor-specific antibody (DSA), HLA and non-HLA. Whilst there is significant evidence around the role of HLA-DSA, there is limited evidence of the role of the latter and the elucidation of these targets is still in its infancy, but it is clear that these may play a significant role in the immune response to a transplanted organ. This literature review aims to summarise what is currently known about the role of non-HLA antibody in renal transplantation.