{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:20:00Z","timestamp":1787682000732,"version":"build-2784847793"},"reference-count":63,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immunological evaluation plays a central role in kidney transplantation, guiding donor selection, risk assessment, and graft outcomes. Although international guidelines are comprehensive, applying them in a real\u2010world low resource setting can be challenging where laboratory capacity varies and access to advanced testing is limited. There is therefore a need for implementable guidelines that reflect local realities while maintaining clinical rigor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Indian Society of Organ Transplantation (ISOT) brought together a multidisciplinary panel of transplant nephrologists, surgeons, clinical immunologists, and histocompatibility laboratory scientists from centers across India. A focused review of international guidelines, systematic reviews, and key studies was undertaken. Draft recommendations were developed and shared ahead of a structured consensus meeting. These were discussed, refined, and finalized through iterative expert deliberation. Recommendations were classified as \u201cRecommended\u201d or \u201cSuggested\u201d based on consensus, and their evidentiary basis was clearly defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 48 consensus recommendations were developed across 13 thematic areas covering key aspects of immunological evaluation. These included immunological risk assessment, antibody screening and crossmatch testing including virtual crossmatch, sensitization assessment, serum sampling and waitlist monitoring, HLA typing, post\u2010transplant monitoring, laboratory governance and immunological assessment in ABO\u2010incompatible transplantation. Of these, 23 were \u201cRecommended\u201d and 25 \u201cSuggested.\u201d Additional guidance focused on resource\u2010adapted and cost\u2010conscious approaches suited to the Indian context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These recommendations offer a practical and standardized framework for immunological evaluation in kidney transplantation within low\u2010 and middle\u2010income settings. Their adoption has the potential to improve patient safety and optimize graft outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70631","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:44:34Z","timestamp":1785509074000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["ISOT Position Statement on Immunological Evaluation in Kidney Transplantation"],"prefix":"10.1111","volume":"40","author":[{"given":"Manish R.","family":"Balwani","sequence":"first","affiliation":[{"name":"Department of Nephrology Saraswati Kidney Care Center  Nagpur Maharashtra India"},{"name":"Department of Nephrology Jawaharlal Nehru Medical College, DMIHER  Wardha Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Kumar","sequence":"additional","affiliation":[{"name":"National Organ and Tissue Transplant Organization (NOTTO) Ministry of Health and Family Welfare, Government of India  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek B.","family":"Kute","sequence":"additional","affiliation":[{"name":"Treasurer Indian Society of Organ Transplantation  Ahmedabad Gujarat India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khushboo","family":"Saxena","sequence":"additional","affiliation":[{"name":"Department of Nephrology Institute of Kidney Diseases and Research Center and Institute of Transplantation Sciences (IKDRC\u2010ITS)  Ahmedabad Gujarat India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranjal","family":"Kashiv","sequence":"additional","affiliation":[{"name":"Department of Nephrology Jawaharlal Nehru Medical College, DMIHER  Wardha Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jigar","family":"Shrimali","sequence":"additional","affiliation":[{"name":"Department of Nephrology Renus Kidney Hospital  Ahmedabad Gujarat India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subho","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Department of Nephrology Institute of Kidney Diseases and Research Center and Institute of Transplantation Sciences (IKDRC\u2010ITS)  Ahmedabad Gujarat India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divyesh P.","family":"Engineer","sequence":"additional","affiliation":[{"name":"Department of Nephrology Institute of Kidney Diseases and Research Center and Institute of Transplantation Sciences (IKDRC\u2010ITS)  Ahmedabad Gujarat India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay Kumar","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Nephrology AIIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Kolte","sequence":"additional","affiliation":[{"name":"Department of Urology Max Super Speciality Hospital \/ Sparsh Urology and Kidney Hospital  Nagpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Pasari","sequence":"additional","affiliation":[{"name":"Department of Nephrology Saraswati Kidney Care Center  Nagpur Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feroz","family":"Aziz","sequence":"additional","affiliation":[{"name":"Department of Nephrology Aster MIMS Hospital  Kozhikode Kerala India"},{"name":"Department of Nephrology IQRAA International Hospital and Research Centre  Kozhikode Kerala India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratik","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Nephrology Rabindranath Tagore International Institute of Cardiac Sciences  Kolkata West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umapati","family":"Hegde","sequence":"additional","affiliation":[{"name":"Department of Nephrology Muljibhai Patel Urological Hospital  Nadiad Gujarat India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak S.","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Nephrology Rabindranath Tagore International Institute of Cardiac Sciences  Kolkata West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhananjai","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Nephrology SMS Medical College  Jaipur Rajasthan India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sourabh","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Nephrology VMMC &amp; 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