Non-HLA Genetics and Application to Living Donor Candidates.

IF 1.6 Q2 SURGERY
Current Transplantation Reports Pub Date : 2025-12-01 Epub Date: 2025-09-05 DOI:10.1007/s40472-025-00495-3
Yasar Caliskan, Baris Afsar, Rengin Elsurer Afsar, Chintalapati Varma, Ozan Aygormez, Krista L Lentine
{"title":"Non-HLA Genetics and Application to Living Donor Candidates.","authors":"Yasar Caliskan, Baris Afsar, Rengin Elsurer Afsar, Chintalapati Varma, Ozan Aygormez, Krista L Lentine","doi":"10.1007/s40472-025-00495-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>This review examines the expanding role of non-human leukocyte antigen (non-HLA) genetic factors in kidney transplantation, with a particular focus on their implications for living donor evaluation and outcomes. It emphasizes the potential of genetic testing to improve risk stratification beyond conventional HLA matching, especially for donor candidates with a family history of hereditary kidney disease.</p><p><strong>Recent findings: </strong>Non-HLA genetic mismatches, including single nucleotide variants affecting minor histocompatibility antigens, can drive alloimmune responses, leading to graft rejection and failure even in HLA-matched transplants. The presence of non-HLA antibodies further contributes to adverse immunological outcomes. Genetic testing in related living donors can uncover monogenic kidney diseases, enabling early identification of at-risk individuals and enhancing donor safety. While polygenic risk scores and gene panels show promise in predicting complications and guiding post-transplant care, most genome-wide association studies have focused on recipients. There remains a significant gap in understanding how donor-specific genetic factors influence post-donation kidney function and long-term health outcomes.</p><p><strong>Summary: </strong>The integration of non-HLA genetic testing into living donor evaluation supports a precision medicine approach to kidney transplantation, offering improved risk assessment and donor-recipient matching. As the field advances, longitudinal studies and robust data collection, particularly around donor genetics, are essential to optimize transplant outcomes, inform clinical decision-making, and uphold ethical standards in donor care.</p>","PeriodicalId":36387,"journal":{"name":"Current Transplantation Reports","volume":"12 1","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435529/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Transplantation Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s40472-025-00495-3","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/5 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose of review: This review examines the expanding role of non-human leukocyte antigen (non-HLA) genetic factors in kidney transplantation, with a particular focus on their implications for living donor evaluation and outcomes. It emphasizes the potential of genetic testing to improve risk stratification beyond conventional HLA matching, especially for donor candidates with a family history of hereditary kidney disease.

Recent findings: Non-HLA genetic mismatches, including single nucleotide variants affecting minor histocompatibility antigens, can drive alloimmune responses, leading to graft rejection and failure even in HLA-matched transplants. The presence of non-HLA antibodies further contributes to adverse immunological outcomes. Genetic testing in related living donors can uncover monogenic kidney diseases, enabling early identification of at-risk individuals and enhancing donor safety. While polygenic risk scores and gene panels show promise in predicting complications and guiding post-transplant care, most genome-wide association studies have focused on recipients. There remains a significant gap in understanding how donor-specific genetic factors influence post-donation kidney function and long-term health outcomes.

Summary: The integration of non-HLA genetic testing into living donor evaluation supports a precision medicine approach to kidney transplantation, offering improved risk assessment and donor-recipient matching. As the field advances, longitudinal studies and robust data collection, particularly around donor genetics, are essential to optimize transplant outcomes, inform clinical decision-making, and uphold ethical standards in donor care.

非hla遗传学及其在活体供体候选人中的应用。
综述目的:本综述探讨了非人类白细胞抗原(non-HLA)遗传因素在肾移植中的作用,特别关注了它们对活体供体评估和结果的影响。它强调了基因检测在传统HLA匹配之外改善风险分层的潜力,特别是对于有遗传性肾脏疾病家族史的供体候选人。最近发现:非hla基因错配,包括影响次要组织相容性抗原的单核苷酸变异,可以驱动同种免疫反应,甚至在hla匹配的移植中导致移植排斥和失败。非hla抗体的存在进一步导致了不良的免疫结果。对相关活体供体进行基因检测可以发现单基因肾脏疾病,使早期识别高危个体成为可能,并提高供体安全性。虽然多基因风险评分和基因面板在预测并发症和指导移植后护理方面显示出希望,但大多数全基因组关联研究都集中在接受者身上。在了解捐赠者特异性遗传因素如何影响捐赠后肾脏功能和长期健康结果方面仍然存在重大差距。摘要:将非hla基因检测整合到活体供体评估中,为肾移植提供了精准医学方法,提供了改进的风险评估和供体-受体匹配。随着该领域的发展,纵向研究和可靠的数据收集,特别是关于供体遗传学的研究,对于优化移植结果,为临床决策提供信息,并维护供体护理的道德标准至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
3.40
自引率
4.80%
发文量
34
期刊介绍: Under the guidance of Dr. Dorry Segev, from Johns Hopkins, Current Transplantation Reports will provide an in-depth review of topics covering kidney, liver, and pancreatic transplantation in addition to immunology and composite allografts.We accomplish this aim by inviting international authorities to contribute review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists.  By providing clear, insightful balanced contributions, the journal intends to serve those involved in the field of transplantation.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信