{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T20:09:37Z","timestamp":1778962177024,"version":"3.51.4"},"reference-count":328,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1]]},"abstract":"\n Background.<\/jats:title>\n There is no standard definition for \u201cHLA incompatible\u201d transplants. For the first time, we systematically assessed how HLA incompatibility was defined in contemporary peer-reviewed publications and its prognostic implication to transplant outcomes.<\/jats:p>\n <\/jats:sec>\n \n Methods.<\/jats:title>\n We combined 2 independent searches of MEDLINE, EMBASE, and the Cochrane Library from 2015 to 2019. Content-expert reviewers screened for original research on outcomes of HLA-incompatible transplants (defined as allele or molecular mismatch and solid-phase or cell-based assays). We ascertained the completeness of reporting on a predefined set of variables assessing HLA incompatibility, therapies, and outcomes. Given significant heterogeneity, we conducted narrative synthesis and assessed risk of bias in studies examining the association between death-censored graft failure and HLA incompatibility.<\/jats:p>\n <\/jats:sec>\n \n Results.<\/jats:title>\n Of 6656 screened articles, 163 evaluated transplant outcomes by HLA incompatibility. Most articles reported on cytotoxic\/flow T-cell crossmatches (n = 98). Molecular genotypes were reported for selected loci at the allele-group level. Sixteen articles reported on epitope compatibility. Pretransplant donor-specific HLA antibodies were often considered (n = 143); yet there was heterogeneity in sample handling, assay procedure, and incomplete reporting on donor-specific HLA antibodies assignment. Induction (n = 129) and maintenance immunosuppression (n = 140) were frequently mentioned but less so rejection treatment (n = 72) and desensitization (n = 70). Studies assessing death-censored graft failure risk by HLA incompatibility were vulnerable to bias in the participant, predictor, and analysis domains.<\/jats:p>\n <\/jats:sec>\n \n Conclusions.<\/jats:title>\n Optimization of transplant outcomes and personalized care depends on accurate HLA compatibility assessment. Reporting on a standard set of variables will help assess generalizability of research, allow knowledge synthesis, and facilitate international collaboration in clinical trials.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/tp.0000000000004262","type":"journal-article","created":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T04:01:09Z","timestamp":1659412869000},"page":"231-253","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Seeking Standardized Definitions for HLA-incompatible Kidney Transplants: A Systematic Review"],"prefix":"10.1097","volume":"107","author":[{"given":"Sukhdeep S.","family":"Jatana","sequence":"first","affiliation":[{"name":"Center for Outcomes Research and Evaluation, Research Institute of McGill University Health Center, Montreal, QC, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hedi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation, Research Institute of McGill University Health Center, Montreal, QC, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurine M.","family":"Bow","sequence":"additional","affiliation":[{"name":"Department of Surgery\/Transplant, Yale University School of Medicine, New Haven, CT."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Cozzi","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy."},{"name":"Transplantation Immunology Unit, Padua University Hospital, Padova, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Batal","sequence":"additional","affiliation":[{"name":"Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tillie","family":"Horak","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre","family":"Amar-Zifkin","sequence":"additional","affiliation":[{"name":"McGill University Health Centre Medical Libraries, Montreal, QC, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carrie","family":"Schinstock","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Medhat","family":"Askar","sequence":"additional","affiliation":[{"name":"Department of Pathology and Lab Medicine, Baylor University Medical Center, Dallas, TX."},{"name":"Department of Lab Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darshana M.","family":"Dadhania","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine\u2014New York Presbyterian Hospital, New York, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Cooper","sequence":"additional","affiliation":[{"name":"Medstar Georgetown Transplant Institute, Washington, DC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarten","family":"Naesens","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward S.","family":"Kraus","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Sapir-Pichhadze","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation, Research Institute of McGill University Health Center, Montreal, QC, Canada."},{"name":"Division of Nephrology and Multi-Organ Transplant Program, Department of Medicine, McGill University, Montreal, QC, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Banff Antibody-Mediated Injury Working Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,8,2]]},"reference":[{"key":"R1-20250604","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1111\/j.1600-6143.2004.00364.x","article-title":"Successful renal transplantation across simultaneous ABO incompatible and positive crossmatch barriers.","volume":"4","author":"Warren","year":"2004","journal-title":"Am 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