The Clinical Importance of Choosing the Right Assay for Detection of Hla-Specific Donor-Reactive Antibodies1

Sumitran-Karuppan, S

doi:10.1097/00007890-199908270-00010

Cited by 17 publications

(6 citation statements)

References 16 publications

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“…In all but one case (patient 025), there was a response in DSA in the first 4 posttransplant weeks. For the rejection group the median time to antibody peak was12.5 days (range, [11][12][13][14][15][16][17][18][19][20]. For nonrejectors, the mean time to peak antibody was longer at 22 days (range, 9 -34).…”

Section: Resultsmentioning

confidence: 99%

Blood Levels of Donor-Specific Human Leukocyte Antigen Antibodies After Renal Transplantation: Resolution of Rejection in the Presence of Circulating Donor-Specific Antibody

Higgins

Hathaway²,

Lowe³

et al. 2007

Transplantation

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Section: Resultsmentioning

confidence: 99%

Blood Levels of Donor-Specific Human Leukocyte Antigen Antibodies After Renal Transplantation: Resolution of Rejection in the Presence of Circulating Donor-Specific Antibody

Higgins

Hathaway²,

Lowe³

et al. 2007

Transplantation

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“…Because of the strong linkage disequilibrium in the HLA system, the results were often and unknowingly erroneous. Furthermore, early developments of ELISA-based detection were not even capable of reliably discriminating between HLA class I and class II-specific antibodies [2].The use of purified HLA proteins coupled to microbeads [3][4][5] gives an assay of much greater fidelity, sensitivity and speed. All these three characteristics are of clinical significance.…”

mentioning

confidence: 99%

“…The use of purified HLA proteins coupled to microbeads [3][4][5] gives an assay of much greater fidelity, sensitivity and speed. All these three characteristics are of clinical significance.…”

mentioning

confidence: 99%

Development of Non-Donor-Specific HLA Antibodies after Kidney Transplantation: Frequency and Clinical Implications

Briggs

Zehnder²,

Higgins³

2008

Contributions to Nephrology

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Patients undergoing renal transplantation frequently have non-donor-specific HLA antibodies (NDSA). There could be NDSA (e.g. a negative crossmatch in a sensitized patient), or could be donor-specific HLA antibodies (DSA) (e.g., antibody-incompatible transplantation). NDSA levels slowly fall in the first month after transplantation, but in some patients their levels initially rise during a rejection episode with increased synthesis of DSA. This could be due to antibodies binding with shared epitopes on donor-specific and non-donor-specific HLA, or due to non-specific immune upregulation. Further investigation of the levels of NDSA in the context of the levels of DSA and other immunoglobulins will lead to new insights into the control of DSA responses.

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“…Numerous reports provide evidence for the deleterious effect of anti-HLA class II IgG antibodies in solid-organ transplantation (5,16,19,37). In clinical transplantation, the incidence of these al-loAbs is suspected when T−/B + XM is observed.…”

Section: Discussionmentioning

confidence: 99%

Specificity of preformed alloantibodies causing B cell positive flow crossmatch in renal transplantation

Lobashevsky¹,

Senkbeil²,

Shoaf³

et al. 2000

Clinical Transplantation

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The specificity of alloantibodies (alloAb) and their clinical significance in association with T-/B+ flow cytometry crossmatch (FCXM) in kidney transplantation are not clearly defined. This study was undertaken to examine the HLA specificity and clinical relevance of Ab causing B+ FCXM in pre-transplant (final XM) recipients' serum samples. Final FCXM serum samples were analyzed from 457 renal transplant patients followed for 10 months post-transplantation. Two hundred and sixty patients had T-/B+ final FCXM. The control group included 197 recipients with T-/B- FCXM at time of transplantation. Class I/class II PRA and specificity of anti-HLA class I and class II Ab in final FCXM serum samples were analyzed by FlowPRA Class I Screening Test and FlowPRA Class II Screening Test. We found no correlation between graft outcome and pre-transplant T-/B- and T-/B+ FCXM status. Additionally, we observed no clinical relevance of B+ FCXM in retransplant patients. However, MCS > or =200 in B+ FCXM retransplant recipients was associated with anti-class II Ab to previous mismatches in regrafted patients (n = 46). This finding was confirmed by specificity analysis of anti-DR/DQ Ab in patients with high ( > or =15%) class II PRA. In 63% (12 of 19) of retransplants having T-/B+ FCXM, we defined the specificity of alloAb to first graft mismatched class II antigens. In contrast, anti-class II Ab was detected in only 5.7% (2 of 35) of single-graft recipients with different PRA values. Significantly greater MCS (240 +/- 61 vs. 163 +/- 48; p = 0.022) was observed in retransplant patients having short ( < or =5 m) previous graft survival time (PGST) than in those with long PGST ( > or =5 m). Only 2% of retransplant recipients with B + FCXM had non-HLA Ab. In contrast, the overwhelming majority of primary recipients had no detectable alloAbs. No significant difference in class I PRA was found between B- and B+ FCXM recipients. However, class II PRA was significantly higher in patients having B + FCXM (p = 0.028). Collectively, these data show that MCS intensity is not always a reliable criterion for anti-HLA Ab detection because of the presence of non-HLA Ab. These results can be explained by low titers of anti-class II Ab, at which concentration these Ab cannot produce a deleterious effect. FlowPRA and Flow screen beads appeared to be reliable and sensitive methods for detection and specificity analysis of anti-class II alloAb.

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The Clinical Importance of Choosing the Right Assay for Detection of Hla-Specific Donor-Reactive Antibodies1

Cited by 17 publications

References 16 publications

Blood Levels of Donor-Specific Human Leukocyte Antigen Antibodies After Renal Transplantation: Resolution of Rejection in the Presence of Circulating Donor-Specific Antibody

Blood Levels of Donor-Specific Human Leukocyte Antigen Antibodies After Renal Transplantation: Resolution of Rejection in the Presence of Circulating Donor-Specific Antibody

Development of Non-Donor-Specific HLA Antibodies after Kidney Transplantation: Frequency and Clinical Implications

Specificity of preformed alloantibodies causing B cell positive flow crossmatch in renal transplantation

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