Detection of antibodies against the human leukocyte antigen (HLA) present on the donor lung allograft is central to determining the pathophysiology and diagnosis of antibody-mediated rejection (AMR). The influence of donor-recipient HLA mismatches on subsequent clinical outcomes was demonstrated in a number of early studies in lung transplantation. 1–4 Additionally, the ability to define the presence or absence of circulating anti-HLA antibodies in patients awaiting lung transplantation facilitates the identification of a suitable donor against whom that recipient is not sensitized.