Histocompatibility considerations for kidney paired donor exchange programs.

Purpose Of Review: To highlight the role of histocompatibility testing in kidney paired donor (KPD) exchange programs as well as the new technological advances that may have an effect on KPD.

Recent Findings: Technological advances in human leukocyte antigen (HLA) antibody identification using the Luminex single-antigen bead multiplexing platform have facilitated virtual cross-matching and the ability to accurately match donor/recipient pairs through KPD. A knowledge of the limitations of this assay is the key to proper interpretation of the data and maximization of this new technology. Novel assays such as C1q and Ig subclass identification may be useful in further determining which HLA antibodies are clinically relevant.

Summary: KPD is an established method for increasing access to transplantation for patients with incompatible live donors. Advances in histocompatibility testing have played a role in the success of KPD.