Accuracy of the median channel shift in the flow cytometry for predicting complement dependent cytotoxicity crossmatching in kidney transplant candidates

Moraes, Priscila de Oliveira; Fagundes, Iara dos Santos; Cardone, Jacqueline Moraes; Gil, Beatriz Chamun; Külzer, Adriane Stefani Silva; Hadi, Riad Abdel; Manfro, Roberto Ceratti; Jobim, Luiz Fernando Job

doi:10.1016/j.trim.2018.10.005

Cited by 6 publications

(6 citation statements)

References 19 publications

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“…It is a common practice to use a larger CS to classify a B cell FCXM as positive compared to classifying a T cell FCXM as positive [19][20][21][22] . Had we applied the 40 CS threshold to classify not only T cell FCXM but also B cell FCXM, 12 of 25 T+B-FCXM would be reclassified as a T+B+ FCXM.…”

Section: Discussionmentioning

confidence: 99%

T-Cell-Positive, B-Cell-Negative Flow Cytometry Crossmatch: Frequency, HLA Locus Specificity, and Mechanisms Among 3073 Clinical Flow Cytometry Crossmatch Tests

Putheti¹,

Sharma²,

Friedlander³

et al. 2022

Exp Clin Transplant

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Section: Discussionmentioning

confidence: 99%

T-Cell-Positive, B-Cell-Negative Flow Cytometry Crossmatch: Frequency, HLA Locus Specificity, and Mechanisms Among 3073 Clinical Flow Cytometry Crossmatch Tests

Putheti¹,

Sharma²,

Friedlander³

et al. 2022

Exp Clin Transplant

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“…This strategy allowed a reduction in the time required to perform the test. Similarly, de Moraes et al 24 concluded in their study that the exclusive use of FCXM as a cell test for pre-transplantation evaluation of anti-donor antibodies is feasible given the safety in terms of predicting CDC negative results and by assessing the risk of a preformed DSA. However, contrary to our expectation, the CIT did not decrease.…”

Section: Discussionmentioning

confidence: 99%

Phasing out the pre-transplant cytotoxicity crossmatch: Are we missing something?

et al. 2021

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Introduction: The anti-human globulin-enhanced complement-dependent cytotoxicity crossmatch (AHG-CDCXM) assay has been used to assess the presence of donor-specific antibodies (DSA) in recipient’s serum before kidney transplantation. The flow cytometric crossmatch (FCXM) assay was first introduced as an additional test. The aim of this study was to clinically validate the single use of the FCXM assay. Methods: This study compared the outcomes of a cohort of kidney transplant patients that underwent FCXM only (FCXM group) versus a cohort of kidney transplant patients that underwent AHG-CDCXM (control group). Results: Ninety-seven patients in the FCXM group and 98 controls were included. All crossmatches in the control group were negative. One patient in the FCXM group had a positive B cell crossmatch. One year after transplantation, there were no significant differences in patient survival (p = 0.591) and graft survival (p = 0.692) between the groups. Also, no significant difference was found in the incidence of Banff ≥ 1A acute cellular rejection episodes (p = 0.289). However, acute antibody-mediated rejections occurred in 3 controls (p = 0.028). Conclusion: The results showed that discontinuing the AHG-CDCXM assay does not modify the clinical outcomes in a 1-year follow-up.

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Section: Discussionmentioning

confidence: 99%

“…A predefined ratio of the fluorescence of the T cells and B cells treated with RS to the fluorescence of the corresponding cells treated with NCS is one approach to classify a FCXM 6 . A fluorescence value that is 2 or 3 standard deviations (SD) above the mean value observed with the NCS is also used to classify a FCXM as a positive or a negative [19][20][21][22][23] . A value that is 2 SD higher than the mean would place the observed value outside the 95% probability and a value that is 3 SD higher would place the observed value outside the 99.7% probability.…”

Section: Discussionmentioning

confidence: 99%

T Cell Positive B Cell Negative Flow Cytometry Crossmatch (FCXM): Frequency, HLA-Locus Specificity, and Mechanisms Among 3073 Clinical FCXM Tests

Putheti

Friedlander

et al. 2021

Preprint

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Background. A T cell positive and B cell negative (T+B-) flow cytometry crossmatch (FCXM) result remains a conundrum since HLA-class I antigens are expressed on both T and B cells. We investigated the frequency, HLA specificity of the antibodies and mechanisms for the T+B- FCXM result. Methods. We analyzed 3073 clinical FCXM tests performed in an American Society of Histocompatibility and Immunogenetics accredited histocompatibility laboratory. The sera associated with the T+B- FCXM were also tested for donor HLA IgG antibodies using LABScreen single antigen assays. Results. Among the 3073 FCXM tests, 1963 were T-B-, 811 were T-B+, 274 were T+B+, and 25 were T+B-. IgG antibodies directed at donor HLA-A, B, or Cw locus determined antigens (DSA) were identified in all 25 sera and the summed mean fluorescence intensity (MFI) of DSA ranged from 212 to 53,187. Correlational analyses identified a significant association between the summed MFI of class I DSA, and the median channel fluorescence (MCF) of T cells treated with the recipient serum (Spearman rank correlation, rs=0.34, P=0.05) but not with the MCF of B cells (rs=0.23, P=0.24). We identified that differential binding of anti-HLA antibodies to T cells and B cells and the B cell channel shift threshold used to classify a B cell FCXM are potential contributors to a T+B- FCXM result. Conclusions. Our analysis of 3073 FCXM, in addition to demonstrating that HLA antibodies directed at HLA-A, B or Cw locus are associated with a T+B- result, identified mechanisms for the surprising T+B- FCXM result.

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Accuracy of the median channel shift in the flow cytometry for predicting complement dependent cytotoxicity crossmatching in kidney transplant candidates

Cited by 6 publications

References 19 publications

T-Cell-Positive, B-Cell-Negative Flow Cytometry Crossmatch: Frequency, HLA Locus Specificity, and Mechanisms Among 3073 Clinical Flow Cytometry Crossmatch Tests

T-Cell-Positive, B-Cell-Negative Flow Cytometry Crossmatch: Frequency, HLA Locus Specificity, and Mechanisms Among 3073 Clinical Flow Cytometry Crossmatch Tests

Phasing out the pre-transplant cytotoxicity crossmatch: Are we missing something?

T Cell Positive B Cell Negative Flow Cytometry Crossmatch (FCXM): Frequency, HLA-Locus Specificity, and Mechanisms Among 3073 Clinical FCXM Tests

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