{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T16:21:16Z","timestamp":1754151676549,"version":"3.41.2"},"reference-count":41,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HLA"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Highly sensitised kidney transplant candidates face substantial barriers to transplantation due to limited donor compatibility. Delisting unacceptable antigens with detectable HLA\u2010specific antibodies can improve transplant access. It is, however, challenging to determine which specificities are safe to delist. Assessment of circulating HLA\u2010specific memory B\u2010cells may support risk stratification. However, current methodologies are limited by the predominant localisation of memory B\u2010cells in secondary lymphoid organs and thus by potential false negativity. BAFF inhibitors, such as belimumab, mobilise memory B\u2010cells into the circulation, which could reduce false\u2010negative evaluations and improve pretransplant risk stratification. We administered off\u2010label treatment with 200\u2009mg of subcutaneous belimumab weekly for 4\u2009weeks to seven highly sensitised patients with limited allocation probability. The clinical aim was to safely increase allocation probability by selectively delisting unacceptable HLA\u2010specificities without detectable B\u2010cell memory. HLA\u2010specific memory B\u2010cell profiles were assessed before and after treatment, revealing significantly broader HLA\u2010specific memory B\u2010cell profiles after belimumab in addition to a significant increase of HLA\u2010antibody MFI in the eluate of stimulated memory B\u2010cells. This strategy may pave the way for a new paradigm in pretransplant immunological risk\u2010stratification, allowing improved assessment of HLA\u2010specific memory B\u2010cell profiles, which could potentially limit the risk of memory responses.<\/jats:p>","DOI":"10.1111\/tan.70285","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T10:03:18Z","timestamp":1750068198000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Belimumab to Aid Pre\u2010Transplant Immunological Risk\u2010Stratification by Uncovering Broader <scp>HLA<\/scp>\u2010Specific Memory B\u2010Cell Profiles"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7135-4752","authenticated-orcid":false,"given":"Dennis A. 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Onno","family":"Teng","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Leiden University Medical Center (LUMC), Leiden University  Leiden the Netherlands"},{"name":"Leiden Transplant Center, Leiden University Medical Center, Leiden University  Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6257-0899","authenticated-orcid":false,"given":"Cees","family":"van Kooten","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Leiden University Medical Center (LUMC), Leiden University  Leiden the Netherlands"},{"name":"Leiden Transplant Center, Leiden University Medical Center, Leiden University  Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6700-188X","authenticated-orcid":false,"given":"Sebastiaan","family":"Heidt","sequence":"additional","affiliation":[{"name":"Department of Immunology, HLA Laboratory Leiden University Medical Center (LUMC)  Leiden the Netherlands"},{"name":"Erasmus MC Transplant Institute, Department of Internal Medicine Erasmus Medical Centre  Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1846-1193","authenticated-orcid":false,"given":"Dave L.","family":"Roelen","sequence":"additional","affiliation":[{"name":"Leiden Transplant Center, Leiden University Medical Center, Leiden University  Leiden the Netherlands"},{"name":"Department of Immunology, HLA Laboratory Leiden University Medical Center (LUMC)  Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9284-3595","authenticated-orcid":false,"given":"Aiko P. 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