ABSTRACT
Historically, immunologic incompatibilities precluded the utilization of many willing and medically suitable potential live kidney donors. These immunologic incompatibilities were the result of donor-specific antibodies (DSA) directed against either human leukocyte antigen (HLA) antigens or the major blood group antigens (ABO). Transplantation across these humoral immunologic barriers resulted in a high incidence of immediate irreversible hyperacute rejection, subsequent acute humoral rejection, or aggressive acute cellular rejection, with unacceptable graft survival rates.
