Prospective multi-centric study to analyze pre-transplant compatibility algorithm for live-related donor kidney transplant in Indian setting: the “Delhi approach”!

Tiwari, Aseem Kumar; Handoo, Anil; Choudhary, Mohit; Mehra, Simmi; Bacchas, Virender; Yadav, Ayushi; Negi, Avinash; Chopra, Ramona

doi:10.1016/j.trim.2021.101487

Cited by 5 publications

(4 citation statements)

References 28 publications

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“…Another study from India by Tiwari et al reported a sensitivity of 12.1% and a specificity of 100% for CDCXM, whereas the sensitivity and specificity for FCXM were 84.8% and 89.6%, respectively. Overall, flow cytometry crossmatch shows a higher sensitivity than CDC crossmatch, whereas CDC crossmatch is found to be more specific than flow cytometry crossmatch [22,23]. antibodies like anti-thymocyte globulin, rituximab (anti-CD20), alemtuzumab (anti-CD52), basiliximab (anti-CD25), and daclizumab (anti-CD25) [20].…”

Section: Flow Cytometry Crossmatch (Fcxm)mentioning

confidence: 99%

“…Finding a suitable organ donor with a low risk of rejection becomes challenging when the patient has a high PRA. In such cases, clinicians may consider exploring strategies to mitigate the risk of AMR [20][21][22][23]. The effectiveness of PRA is influenced by both the composition of the panel and the methodology employed for antibody detection.…”

Section: Panel-reactive Antibodies (Pra)mentioning

confidence: 99%

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Histocompatibility Testing: A Fundamental Aspect of Renal Transplant Workup

Mishra,

Chandra,

Raina

2024

Transplantology

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Histocompatibility testing is pivotal in any renal transplantation workup, aimed at enhancing prospective donor recipient compatibility and improving transplant outcomes. The evolution and advancement of histocompatibility testing, particularly HLA typing, have significantly improved its precision. This study outlines the historical progression from serologic to DNA-based HLA typing, emphasizing the role of HLA proteins in immune response. Anti-HLA antibodies, targeting HLA proteins, pose challenges in renal transplantation. Monitoring and managing these antibodies are critical for renal transplant success. Complement-dependent cytotoxicity crossmatch and flow cytometry crossmatch are essential techniques for assessing donor–recipient compatibility. Panel-reactive antibody assesses antibodies against a panel of donor antigens, often HLA. Higher PRA levels (percentage) complicate donor matching, requiring specialized protocols. Virtual crossmatch evaluates recipient anti-HLA antibodies against potential donors through synthetic beads. This approach predicts crossmatch outcomes by comparing antibody profiles, offering a valuable tool for the risk assessment of renal transplantation. Despite advancements, a comprehensive understanding of alloreactive immune responses requires a combination of assays, emphasizing the importance of a multifaceted approach in histocompatibility testing. This is an attempt to compile the relevant information, providing a basis for comparison in a clear and foundational format for histocompatibility testing laboratories.

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Section: Flow Cytometry Crossmatch (Fcxm)mentioning

confidence: 99%

Section: Panel-reactive Antibodies (Pra)mentioning

confidence: 99%

Histocompatibility Testing: A Fundamental Aspect of Renal Transplant Workup

Mishra,

Chandra,

Raina

2024

Transplantology

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“…The signal intensity emitted by each bead is compared to that of negative control sera and beads included in the bead preparation to determine whether each bead is positive or negative for the bound alloantibody. 2,7…”

Section: Sab Assaymentioning

confidence: 99%

“…Furthermore, the recipient's HLA typing aids in excluding any autoantibodies, if present. 7 The successful interpretation of SAB testing is dependent upon various factors, including but not restricted to the patient's clinical background, cross-reactive groups, MFI, and comprehensive HLA coverage. While there have been notable advancements in this technique, it is important to acknowledge certain limitations, which include issues related to non-specific background signals, the absence of standardized procedures, and the complexities involved in data interpretation.…”

Section: Introductionmentioning

confidence: 99%