ISOT Position Statement on Immunological Evaluation in Kidney Transplantation.
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Balwani Manish R, Kumar Anil, Kute Vivek B, Saxena Khushboo, Kashiv Pranjal, Shrimali Jigar, Banerjee Subho, Engineer Divyesh P, Agarwal Sanjay Kumar, Kolte Sanjay, Pasari Amit, Aziz Feroz, Das Pratik, Hegde Umapati, Ray Deepak S, Agarwal Dhananjai, Sharma Sourabh, Bhawane Amol, Prasad Narayan, Chaudhury Arpita Ray, Raju Sreebhushan, Tapiawala Shruti, Jain Vikas, Das Debasis, Deshpande Vrushali, Ramteke Vishal, Sharma Ashish, Bhalla Anil K, Guleria Sandeep, Abraham Georgi, Parmar Vishal, Selvakumar Sakthi, Godara Suraj M, Gothwal Kapil, Chauhan Sanshriti, Meshram Hari Shankar
Аннотация
METHODS: 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 "Recommended" or "Suggested" based on consensus, and their evidentiary basis was clearly defined.
RESULTS: 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-transplant monitoring, laboratory governance and immunological assessment in ABO-incompatible transplantation. Of these, 23 were "Recommended" and 25 "Suggested." Additional guidance focused on resource-adapted and cost-conscious approaches suited to the Indian context.
CONCLUSIONS: These recommendations offer a practical and standardized framework for immunological evaluation in kidney transplantation within low- and middle-income settings. Their adoption has the potential to improve patient safety and optimize graft outcomes.