Sensitization in organ transplantation: Assessment of Risk (STAR) 2025 meeting group report
Year: 2026
Type: article
Abstract: 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.
Authors: Carrie A. Schinstock, Howard Gebel, Idoia Gimferrer, Marlena Habal, Sebastiaan Heidt, Michelle J. Hickey, Annette M. Jackson, Vasilis Kosmoliaptsis, Roslyn B. Mannon, Maria Meneghini, Michael Mengel, Anna Morris, Maarten Naesens, Elaine Reed, Aleksandar Senev, Olivier Thaunat, Nicole Valenzuela, Chris Wiebe, Anat R. Tambur
Institutions: Mayo Clinic, Emory University, Bloodworks Northwest, New York University, Leiden University Medical Center, Erasmus MC, Erasmus MC Transplant Institute, University of California, Los Angeles, Duke University, Duke Medical Center, University of Cambridge, University of Nebraska Medical Center, Vall d'Hebron Hospital Universitari, University of Alberta, KU Leuven, Northwestern University, Hospices Civils de Lyon, Hôpital Edouard Herriot, MaineHealth, University of Manitoba
Language: English
Subfield: Transplantation
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,300
OpenAlex ID: W7119484279