Importance of the Autocontrol Crossmatch in Human Renal Transplantation

Cross, Donald E.; Greiner, Robert; Whittier, Frederick C.

doi:10.1097/00007890-197604000-00006

Cited by 50 publications

(14 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All cell-based assays are subject to falsepositive results caused by autoantibodies and non-HLA antibodies 10,[15][16][17][18][19][20][21] as well as false-negative results when the antibody is very low titer but still has clinical relevance. 22,23 Cell-based assays are now routinely augmented by solid-phase assays, with significantly improved sensitivity and specificity.…”

Section: Cell-based Assays: Detecting Hla Antibodies Before Solid-phamentioning

confidence: 99%

Utility of HLA Antibody Testing in Kidney Transplantation

Konvalinka¹,

Tinckam

2015

Journal of the American Society of Nephrology

165

135

View full text Add to dashboard Cite

HLA antigens are polymorphic proteins expressed on donor kidney allograft endothelium and are critical targets for recipient immune recognition. HLA antibodies are risk factors for acute and chronic rejection and allograft loss. Solid-phase immunoassays for HLA antibody detection represent a major advance in sensitivity and specificity over cell-based methods and are widely used in organ allocation and pretransplant risk assessment. Post-transplant, development of de novo donorspecific HLA antibodies and/or increase in donor-specific antibodies from pretransplant levels are associated with adverse outcomes. Although single antigen bead assays have allowed sensitive detection of recipient HLA antibodies and their specificities, a number of interpretive considerations must be appreciated to understand test results in clinical and research contexts. This review, which is especially relevant for clinicians caring for transplant patients, discusses the technical aspects of single antigen bead assays, emphasizes their quantitative limitations, and explores the utility of HLA antibody testing in identifying and managing important pre-and post-transplant clinical outcomes.

show abstract

Section: Cell-based Assays: Detecting Hla Antibodies Before Solid-phamentioning

confidence: 99%

Utility of HLA Antibody Testing in Kidney Transplantation

Konvalinka¹,

Tinckam

2015

Journal of the American Society of Nephrology

165

135

View full text Add to dashboard Cite

show abstract

“…However, the limitations of the CDC assay have long been appreciated. Because CDC detects antibodies that are not necessarily harmful to a proposed transplant (e.g., immunoglobulin (Ig)-M non-HLAspecific antibodies) [2][3][4][5][6], a positive cross-match may unnecessarily deny transplantation. Conversely, when used in isolation, the CDC test fails to identify renal transplants where there is increased risk of early rather than immediate immunological graft loss.…”

Section: Lymphocytotoxicitymentioning

confidence: 99%

Back to the future: application of contemporary technology to long-standing questions about the clinical relevance of human leukocyte antigen-specific alloantibodies in renal transplantation

et al. 2009

View full text Add to dashboard Cite

“…If positive results are obtained, a variety of tests can be used to characterize the antibody. A recipient autologous XM should be performed either to rule out autoantibody as the cause of the (+) XM or to determine its impact on the apparent titer of DSA (7, 9). While less common than among recipients, autoantibody may also be present in the donor, potentially yielding a false‐positive result or even making the XM impossible to interpret.…”

Section: Immunologic Risk Assessmentmentioning

confidence: 99%

Transplanting patients with a positive donor‐specific crossmatch: A single center's perspective

Montgomery

Zachary

2004

Pediatric Transplantation

162

131

View full text Add to dashboard Cite

An increasing number of individuals with end-stage renal disease have become sensitized to human leukocyte antigens (HLA). Sensitization can have a profound impact on the likelihood of obtaining a requisite negative crossmatch (-XM) with a potential donor. Technologic breakthroughs in our ability to diagnose antibody-mediated rejection (AMR) and monitor anti-HLA antibodies has set the stage for a renascence in the understanding and treatment of individuals who harbor donor-specific antibody (DSA). Promising early results from single institutions that have developed preconditioning protocols allowing successful transplantation of XM (+) patients have encouraged other centers to adopt these protocols. Sensitized patients represent a great challenge for the clinician and there is much that remains unknown about the assessment and treatment of these patients. We have successfully preconditioned and transplanted more than 80 patients over a 5-yr period. As our understanding of these patients has increased, we have progressed from a 'one size fits all' approach to therapy to more rational, individualized treatment plans that take into account the varying immunologic risk that each patient possesses. In this article we have summarized our evolving experience with the assessment, treatment, transplantation, and monitoring of patients who undergo preconditioning for a (+) XM with a live donor.

show abstract

Importance of the Autocontrol Crossmatch in Human Renal Transplantation

Cited by 50 publications

References 0 publications

Utility of HLA Antibody Testing in Kidney Transplantation

Utility of HLA Antibody Testing in Kidney Transplantation

Back to the future: application of contemporary technology to long-standing questions about the clinical relevance of human leukocyte antigen-specific alloantibodies in renal transplantation

Transplanting patients with a positive donor‐specific crossmatch: A single center's perspective

Contact Info

Product

Resources

About