Reassessment of T Lymphocytes Crossmatches Results Prediction With Luminex Class I Single Antigen Flow Beads Assay

Visentin, Jonathan; Bachelet, Thomas; Borg, Cécile; Franchini, Nicolas; Nong, Thoa; Lee, Jar-How; Couzi, Lionel; Merville, Pierre; Guidicelli, Gwendaline; Taupin, Jean‐Luc

doi:10.1097/tp.0000000000001239

Cited by 25 publications

(32 citation statements)

References 26 publications

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“…In parallel, at bead level, we also observed that MFI from untreated serum was a poor predictor of complement interference occurrence in comparison with the treated condition. Interestingly, the optimal EDTA MFI thresholds for predicting complement interference described here are similar to those we recently reported for T‐lymphocyte complement‐dependent cytotoxicity crossmatch results prediction, but also to those we and others described for C1q‐ and C3d‐binding ability . These concordant findings emphasize the tight link that associates the ability of HLA antibodies to strongly activate the complement and the interference phenomenon.…”

Section: Discussionsupporting

confidence: 90%

Prevalence, distribution and amplitude of the complement interference phenomenon in single antigen flow beads assays

Guidicelli

Visentin

Franchini

et al. 2018

HLA

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HLA antibody detection with single antigen flow beads (SAFB) assays is impaired by complement interference whose frequency, predictability and distribution among HLA antigens have not been analyzed in large cohorts. We compared in two patients' cohorts the routine follow-up SAFB profiles obtained in class I (n = 129) and class II (n = 85) with and without ethylenediaminetetraacetic acid (EDTA)-treatment. The presence of complement interference was defined according to the reproducibility of the SAFB assays evaluated with our class I and II routine positive control sera. Interference occurred in 29.5% and 45.9% of patients in class I and II, respectively. In the untreated condition, at serum level, neither the number of positive beads, the highest bead mean fluorescence intensity (MFI) nor MFI at bead level, satisfactorily predicted interference. HLA-C were the least affected among class I beads. HLA-DQ beads were the most affected in class II. At least one antibody specificity was falsely negative without EDTA for about 3% of sera in class I and 9% in class II. EDTA-treatment did not significantly modify the low-MFI strengths (500-3000 range). This study emphasizes the high frequency of complement interference and the importance and advantages of systematically pretreating sera with EDTA before performing SAFB assays.

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Section: Discussionsupporting

confidence: 90%

Prevalence, distribution and amplitude of the complement interference phenomenon in single antigen flow beads assays

Guidicelli

Visentin

Franchini

et al. 2018

HLA

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“…The data presented here also confirms the work of Honger et al where lymphocytes which are homozygous for HLA‐A2 express on average twice the amount of antigen as heterozygous individuals . Although Visentin et al only show slightly higher positivity in a crossmatch test with specific antibody against lymphocytes which are homozygous for HLA antigens, Honger's team showed a significant difference. Further work with crossmatches using HUVECs which are homozygous for specific HLA antigen would be beneficial.…”

Section: Discussionsupporting

confidence: 90%

HLA expression levels of unstimulated and cytokine stimulated human umbilical vein endothelial cells

Carey

Poulton

Poles

2020

HLA

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Transplant rejection occurs following recipient recognition of mismatched HLA on donor tissue, but active rejection is dependent not only upon the severity of the T cell or alloantibody response, but also upon the cell surface expression of target HLA molecules. To investigate the variation in HLA expression using a model of endothelium, human umbilical vein endothelial cell (HUVEC) cultures were generated from 48 umbilical cords donated consecutively following planned caesarean section. HUVECs were stimulated using the cytokines tumour necrosis factor alpha and interferon gamma and HLA expression of unstimulated and stimulated cells determined using flow cytometry. HLA-A2, HLA-A3 and HLA-C antigens all showed a modest increase in expression for 12 hours post cell activation, followed by a more pronounced response over the next 24 to 36 hours. Each of these antigens increased by up to 40 times over unstimulated levels and in addition cells homozygous for specific HLA antigens on average had twice the amount of antigen expressed compared with cells heterozygous for that antigen, both when unstimulated and following cytokine stimulation. Cell activation is an important consideration in the assessment of transplant risk and may help progress towards understanding why rejection does not always occur in the presence of significant donor specific antibody. This data also confirms guidelines for transplantation, which recommend doubling the specific antibody level when considering immunological risk for homozygous donors. K E Y W O R D S cell activation, cytokine, endothelial cell, HLA upregulation, HUVEC

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“…These results identified several potentially modifiable risk factors associated with EHR, including reduction of CMV infection, improvements in deceased donor maintenance, and reduction of cold ischemia time and DGF . These interventions require changes in allocation policies and funding for organ procurement organizations and CMV prophylaxis.…”

Section: Discussionmentioning

confidence: 97%

Early hospital readmission after kidney transplantation under a public health care system

Tavares

Cristelli

Paula

et al. 2019

Clinical Transplantation

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Early hospital readmission (EHR) is associated with increased mortality after kidneytransplantation. This is influenced by population demographics and the comprehensiveness of the healthcare system. We investigated the incidence and risk factors associated with EHR and 1-year patient and graft survivals. Methods:We included all recipients of kidney transplant between 2011 and 2012.We excluded recipients younger than 18 years, retransplants and who died or lost the graft during the index hospital admission.Results: Among 1175 recipients, the incidence of EHR was 26.6%. The main reasons for EHR were infection (67%), surgical complications (14%), and metabolic disturbances (11%). Independent risk factors associated with EHR were recipient age (OR = 1.95, 95% CI 1.46-2.63, P < 0.001), CMV serology negative (OR = 2.2, 95% CI 1.31-3.65, P = 0.003), use of rabbit anti-thymocyte globulin (OR = 2.06, 95% CI 1.33-3.13, P < 0.001), treatment for acute rejection during index hospitalization (OR = 1.68, 95% CI 1.15-2.47, P = 0.008), and length of stay (OR = 1.72, 95% CI 1.18-2.5, P = 0.005). Patient (88.8% vs 97.6%, P < 0.001) and death-censored graft (97.4% vs 99.0%, P < 0.001) survivals were inferior comparing patients with and without EHR.Conclusion: EHR was independently associated with mortality (OR 4.01, 95% CI 2.13-7.54, P < 0.001), but its incidence and causes are directly related to the local characteristics of the population and healthcare system. K E Y W O R D S early readmission, kidney transplantation, mortality, prognosis S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section at the end of the article. How to cite this article: Tavares MG, Cristelli MP, Ivani de Paula M, et al. Early hospital readmission after kidney transplantation under a public health care system. Clin

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Reassessment of T Lymphocytes Crossmatches Results Prediction With Luminex Class I Single Antigen Flow Beads Assay

Abstract: Antibodies against HLA-A, -B, or -Cw behave differently. A homozygous HLA target does not trigger a twice higher XM positivity. Multiple antibodies are better evaluated through the immunodominant DSA MFI than through the sum of DSA MFI.

Cited by 25 publications

References 26 publications

Prevalence, distribution and amplitude of the complement interference phenomenon in single antigen flow beads assays

Prevalence, distribution and amplitude of the complement interference phenomenon in single antigen flow beads assays

HLA expression levels of unstimulated and cytokine stimulated human umbilical vein endothelial cells

Early hospital readmission after kidney transplantation under a public health care system

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