is available online at doi.org/10.1097/TP.0000000000005363. Supplemental digital content (SDC) is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (www.transplantjournal.com). Correspondence: Idoia Gimferrer, MD, PhD, Bloodworks Northwest, Immunogenetics/ HLA Laboratory, Seattle, WA 98104. (igimferrer@bloodworksnw.org). Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0041-1337/20/1098-e409 DOI: 10.1097/TP.0000000000005363 Original Clinical Science—General Copyright © 2025 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. e410 Transplantation ■ August 2025 ■ Volume 10 9 ■ Number 8 www.transplantjournal.com anti-HLA DSAs.1,5 Several studies have attempted to define new non-HLA targets as being associated with AMR and/ or impact allograft survival.1,4,10-19 However, substantial heterogeneity exists between studies, potentially explained by the difficulty of developing validated tests for non-HLA antibodies.5 These uncertainties are triggered by the dif ferences across study design related to the type of assays used (solid-phase or cell-based), lack of adequate charac terization of anti-HLA DSAs across data sets, timing of non-HLA antibody sampling, and absence of clear AMR cases mediated through specific non-HLA antibodies for clinical validation.11,20 Accordingly, the Sen
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