IMMUNOLOGY OF LUNG TRANSPLANTATION

HLA SYSTEM AND CROSSMATCH TECHNIQUES - A DETAILED REVIEW FOR PULMONOLOGISTS

Abstract

Lung transplantation, although essential for patients with advanced respiratory diseases, presents significant immunological challenges. Donor-recipient compatibility, mediated by the HLA system, is crucial. This review aims to present pulmonologists with the HLA system and pre-transplant crossmatch tests, which are essential for clinical decision-making. The HLA system (human MHC) and its classes (I and II) are presented, detailing their role in cellular and humoral immunity, respectively. Crossmatch techniques (CDC, FCXM, Luminex) are described, emphasizing their indications, limitations, and advantages. Sensitization in lung transplantation, including the role of donor-specific antibodies (DSA), is discussed, alongside desensitization strategies. Comprehensive knowledge of the HLA system and crossmatch techniques is fundamental to optimizing donor-recipient compatibility, preventing rejection, and improving survival in lung transplantation. The integration of immunological knowledge and clinical decision-making is essential for the success of this complex therapy.