Tissue typing for kidney transplantation for the general nephrologist

ABSTRACT Tissue typing is the process by which an individual's human leukocyte antigens (HLA) are determined. In transplantation, this vital process allows the immunologic or rejection risk of a donor–recipient pairing to be assessed through reviewing their HLA matching and whether any anti‐HLA antibodies present in recipient serum are donor specific. Tissue typing has increased in sophistication over time which has allowed a deeper appreciation of the antigenically important parts of HLA and increased the complexity of determining immunologic risk. SUMMARY AT A GLANCE This review explains the complexity and shortcomings of serological and molecular human leukocyte antigens (HLA) typing, which are critical in the assessment of immunological risks for potential kidney transplant candidates. Consequently, the determination of HLA structure using molecular typing has enabled a more accurate assessment of HLA compatibility between donors and recipients.