The human leukocyte antigen (HLA) system represents the loci of genes that determine tissue compatibility and remains the standard triage test for organ allocation worldwide. HLA-incompatibility is associated with an increased risk of de novo donor specific anti-HLA antibody development, acute and chronic rejection often resulting in premature allograft loss and increased sensitization that substantially reduces the possibility of re-transplantation. Over the last decade, HLA-typing has evolved from serological to high resolution molecular typing, which more precisely defines the immunological profiles of individuals, thereby providing a more comprehensive and accurate assessment of tissue compatibility in transplantation. A greater understanding of the HLA molecular structure has led to advances in the development of molecular mismatch methods to determine HLA immunogenicity, and when combined with comprehensive anti-HLA antibody profiling, these assays have provided a more precise assessment of B cell allo-immune risk and prognostication of adverse allograft outcomes. With the gradual phasing out of pre-transplant cytotoxicity cell-based crossmatch assays and availability of novel methods to assess HLA- and non-HLA molecular compatibility, clinicians and scientists are challenged with several issues on how to navigate a large number of immune- and non-immune determinants of donor/recipient compatibility at the time of donor kidney allocation.
The current concept and understanding of allo-immunity in kidney transplantation have focussed primarily on the analysis of B cell epitopes to assess the immunogenicity of tissue compatibility in organ transplantation. However, it does not consider the potential roles of T-cell epitope matching (indirect T cell response) and the evolving roles of macrophages, natural killer (NK) cells, NK T cells, dendritic cells and regulatory T cells in the allo-immune response.
The goal of this research topic is to provide fundamental insights, translational potential, and limitations of current concepts of B and T cell HLA allo-immunity and non-HLA immunity in kidney transplantation. It will also provide an overview of the role of innate and adaptive immunity as determinants of transplant outcomes and how big data analytics may help to further define and discriminate the immunological risk profile of patients with kidney transplants. We welcome submissions of Review, Mini-Review, Opinion, as well as Original Research articles focusing on, but not strictly limited to the following topics:
1) HLA structure – navigating through HLA structure, B-cell epitopes, structure-based risk modeling, immunogenicity algorithms to inform decision making their translational potential in kidney organ allocation
2) Clinical approach to HLA and non-HLA immunity in kidney transplantation: perspectives from immunologists, transplant clinicians, policy makers and patient groups
a. Transplantation equity - indigenous and ethnic minorities, gender disparity
b. Genetic ancestry
c. Patients’ perspectives
3) Analysis of B and T cell epitopes to predict the risk of rejection and sensitization after kidney transplantation: from bench to bedside and back again
4) Harnessing NK and NK T cells: from cancer therapy to kidney organ transplantation
5) Targeting macrophages in autoimmune disease and cancer treatment – translatability to kidney organ transplantation
6) Improved analysis, utilization and clinical application and interpretation of big data for immunological risk stratification and kidney organ allocation: statistical methods beyond conventional survival analysis.
a. Novel analysis - machine learning to inform immunological risk
b. Integration of transcriptomics in the reporting of kidney biopsies
c. Single cell transcriptomics to predict kidney rejection
The human leukocyte antigen (HLA) system represents the loci of genes that determine tissue compatibility and remains the standard triage test for organ allocation worldwide. HLA-incompatibility is associated with an increased risk of de novo donor specific anti-HLA antibody development, acute and chronic rejection often resulting in premature allograft loss and increased sensitization that substantially reduces the possibility of re-transplantation. Over the last decade, HLA-typing has evolved from serological to high resolution molecular typing, which more precisely defines the immunological profiles of individuals, thereby providing a more comprehensive and accurate assessment of tissue compatibility in transplantation. A greater understanding of the HLA molecular structure has led to advances in the development of molecular mismatch methods to determine HLA immunogenicity, and when combined with comprehensive anti-HLA antibody profiling, these assays have provided a more precise assessment of B cell allo-immune risk and prognostication of adverse allograft outcomes. With the gradual phasing out of pre-transplant cytotoxicity cell-based crossmatch assays and availability of novel methods to assess HLA- and non-HLA molecular compatibility, clinicians and scientists are challenged with several issues on how to navigate a large number of immune- and non-immune determinants of donor/recipient compatibility at the time of donor kidney allocation.
The current concept and understanding of allo-immunity in kidney transplantation have focussed primarily on the analysis of B cell epitopes to assess the immunogenicity of tissue compatibility in organ transplantation. However, it does not consider the potential roles of T-cell epitope matching (indirect T cell response) and the evolving roles of macrophages, natural killer (NK) cells, NK T cells, dendritic cells and regulatory T cells in the allo-immune response.
The goal of this research topic is to provide fundamental insights, translational potential, and limitations of current concepts of B and T cell HLA allo-immunity and non-HLA immunity in kidney transplantation. It will also provide an overview of the role of innate and adaptive immunity as determinants of transplant outcomes and how big data analytics may help to further define and discriminate the immunological risk profile of patients with kidney transplants. We welcome submissions of Review, Mini-Review, Opinion, as well as Original Research articles focusing on, but not strictly limited to the following topics:
1) HLA structure – navigating through HLA structure, B-cell epitopes, structure-based risk modeling, immunogenicity algorithms to inform decision making their translational potential in kidney organ allocation
2) Clinical approach to HLA and non-HLA immunity in kidney transplantation: perspectives from immunologists, transplant clinicians, policy makers and patient groups
a. Transplantation equity - indigenous and ethnic minorities, gender disparity
b. Genetic ancestry
c. Patients’ perspectives
3) Analysis of B and T cell epitopes to predict the risk of rejection and sensitization after kidney transplantation: from bench to bedside and back again
4) Harnessing NK and NK T cells: from cancer therapy to kidney organ transplantation
5) Targeting macrophages in autoimmune disease and cancer treatment – translatability to kidney organ transplantation
6) Improved analysis, utilization and clinical application and interpretation of big data for immunological risk stratification and kidney organ allocation: statistical methods beyond conventional survival analysis.
a. Novel analysis - machine learning to inform immunological risk
b. Integration of transcriptomics in the reporting of kidney biopsies
c. Single cell transcriptomics to predict kidney rejection
