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Sensitization in organ transplantation: Assessment of Risk (STAR) 2025 meeting group report.

Title: Sensitization in organ transplantation: Assessment of Risk (STAR) 2025 meeting group report.
Authors: Schinstock, Carrie A; Gebel, Howard; Gimferrer, Idoia; Habal, Marlena; Heidt, Sebastiaan; Hickey, Michelle J; Jackson, Annette M; Kosmoliaptsis, Vasilis; Mannon, Roslyn B; Meneghini, Maria; Mengel, Michael; Morris, Anna; Naesens, Maarten; Reed, Elaine; Senev, Aleksandar; Thaunat, Olivier; Valenzuela, Nicole; Wiebe, Chris; Tambur, Anat R; STAR Working Group Members
Publisher Information: Elsevier; Department of Surgery; //doi.org/10.1016/j.ajt.2025.12.286
Publication Year: 2026
Collection: Apollo - University of Cambridge Repository
Subject Terms: HLA laboratory; alloantibody; antibody-mediated rejection; donor-derived cell-free DNA; donor-specific antibody; molecular mismatch; natural killer cells; non-HLA antibody
Description: The Sensitization in Transplantation: Assessment of Risk initiative aimed to translate human leukocyte antibody (HLA) laboratory data into clinical practice and identify key knowledge gaps to guide future research. The Sensitization in Transplantation: Assessment of Risk working group has held 3 consensus meetings and published reports that have influenced clinical care. In 2025, the group focused on 5 evolving areas: donor-derived cell-free DNA tests, innate immunity in allograft rejection, immunogenicity and antigenicity, HLA antibody quantification, and non-HLA antibodies. Three years of work culminated in 2 webinars and a February 2025 community meeting, which are summarized in this report. The group outlined considerations for integrating donor-derived cell-free DNA tests into practice, proposed a definition for genetic prediction of natural killer-cell missing self, and discussed monocyte activation via the Signal-regulatory protein alpha - cluster of differentiation 47 (SIRPα-CD47) pathway. They reviewed molecular mismatch approaches, limitations, and immune-recognition complexities. Finally, they provided updates on HLA antibody quantification, non-HLA antibodies, and ongoing studies addressing critical knowledge gaps.
Document Type: article in journal/newspaper
File Description: Print-Electronic; application/pdf
Language: English
Relation: https://www.repository.cam.ac.uk/handle/1810/397559; https://doi.org/10.17863/CAM.126662
DOI: 10.17863/CAM.126662
Availability: https://www.repository.cam.ac.uk/handle/1810/397559; https://doi.org/10.17863/CAM.126662
Rights: Attribution 4.0 International ; https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.499E6DAB
Database: BASE