Clinical significance of anti-HLA antibodies detected by Luminex®: Enhancing the interpretation of CDC-BXM and important post-transplantation monitoring tools

被引:34
作者
Eng, Hooi Sian [1 ,2 ,3 ]
Bennett, Greg [3 ]
Bardy, Peter [1 ,3 ,4 ]
Coghlan, Patrick [5 ]
Russ, Graeme R. [1 ,2 ,3 ,6 ]
Coates, P. Toby H. [1 ,2 ,3 ]
机构
[1] Univ Adelaide, Dept Med, Adelaide, SA 5001, Australia
[2] Queen Elizabeth Hosp, Dept Nephrol & Transplantat Serv, Woodville, SA 5011, Australia
[3] Australian Red Cross Blood Serv, Natl Transplantat Serv, Adelaide, SA, Australia
[4] Queen Elizabeth Hosp, Dept Haematol & Oncol, Woodville, SA 5011, Australia
[5] Australian Red Cross Blood Serv, Natl Transplantat Serv, Melbourne, Vic, Australia
[6] Queen Elizabeth Hosp, ANZDATA Registry, Woodville, SA 5011, Australia
关键词
HLA antibodies; Luminex (R); Crossmatch; Renal transplantation; Monitoring; HIGHLY SENSITIZED PATIENTS; CELL CROSS-MATCH; COMPLEMENT-DEPENDENT CYTOTOXICITY; RENAL-TRANSPLANT RECIPIENTS; FLOW-CYTOMETRY; KIDNEY-TRANSPLANTATION; ALLOGRAFT SURVIVAL; PREDICTIVE-VALUE; UNITED-STATES; BCL-XL;
D O I
10.1016/j.humimm.2009.06.010
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
071005 [微生物学]; 100108 [医学免疫学];
摘要
B-cell crossmatch (BXM) was originally introduced to increase the sensitivity to detect anti-H LA antibodies of conventional CDC crossmatch in renal transplantation. Newer techniques such as Luminex (R) have greater sensitivity in detecting anti-HLA antibodies but have not been directly evaluated versus BXM. We discuss our experience with Luminex testing and the significance of donor-specific antibodies (DSA) defined by Luminex in three populations, as compared with the CDC crossmatch. In the general transplant Population, Luminex-defined DSA were found in only one third of positive CDC-BXM and were associated with graft rejection. Luminex testing enhanced the interpretation of CDC-BXM and identified patients with clinically relevant BXM. In the highly sensitized transplant population, Luminex-defined DSA were found in two thirds of positive BXM and were a better predictor of graft rejection. Therefore, Luminex assays rather than CDC-BXM should be used to facilitate kidney allocation in highly sensitized patients. In the post-transplantation population, Luminex antibody monitoring for DSA was shown to be important, as it defined low-level de novo DSA that were associated with development of transplant glomerulopathy and a significant predictor of graft loss in those patients. Thus Luminex testing facilitated the interpretation of CDC-BXM and provided a useful predictive tool for the detection of clinically significant DSA in post-transplantation antibody monitoring. (C) 2009 Published by Elsevier Inc. on behalf of American Society for Histocompatibility and Immunogenetics.
引用
收藏
页码:595 / 599
页数:5
相关论文
共 60 条
[41]
OPELZ G, 1992, TRANSPLANT P, V24, P2342
[42]
OPELZ G, 1990, TRANSPLANT P, V22, P1878
[43]
Impact of HLA antibodies on transplant glomerulopathy [J].
Palomar, R ;
López-Hoyos, M ;
Pastor, JM ;
Fernández-Fresnedo, GF ;
Rodrigo, E ;
Ruiz, JC ;
Cotorruelo, JG ;
Valero, R ;
Castañeda, O ;
San Segundo, D ;
Arias, M .
TRANSPLANTATION PROCEEDINGS, 2005, 37 (09) :3830-3832
[44]
Immunological monitoring of posttransplant allograft sensitization following living related donor renal transplantation [J].
Panigrahi, A ;
Deka, R ;
Bhowmik, D ;
Tiwari, SC ;
Mehra, NK .
TRANSPLANTATION PROCEEDINGS, 2004, 36 (05) :1336-1339
[45]
SIGNIFICANCE OF POSITIVE CROSSMATCH TEST IN KIDNEY TRANSPLANTATION [J].
PATEL, R ;
TERASAKI, PI .
NEW ENGLAND JOURNAL OF MEDICINE, 1969, 280 (14) :735-&
[46]
RUSS GR, 1987, TRANSPLANT P, V19, P785
[47]
Transolant accommodation in highly sensitized patients: A potential role for Bcl-xL and alloantibody [J].
Salama, AD ;
Delikouras, A ;
Pusey, CD ;
Cook, HT ;
Bhangal, G ;
Lechler, RI ;
Dorling, A .
AMERICAN JOURNAL OF TRANSPLANTATION, 2001, 1 (03) :260-269
[48]
FACTORS AFFECTING THE WAITING TIME OF CADAVERIC KIDNEY-TRANSPLANT CANDIDATES IN THE UNITED-STATES [J].
SANFILIPPO, FP ;
VAUGHN, WK ;
PETERS, TG ;
SHIELD, CF ;
ADAMS, PL ;
LORBER, MI ;
WILLIAMS, GM .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1992, 267 (02) :247-252
[49]
Prevalence of donor-specific anti-HLA antibodies during episodes of renal allograft rejection [J].
Supon, P ;
Constantino, D ;
Hao, P ;
Cagle, L ;
Hahn, A ;
Conti, DJ ;
Freed, BM .
TRANSPLANTATION, 2001, 71 (04) :577-580
[50]
Predicting kidney graft failure by HLA antibodies: a prospective trial [J].
Terasaki, PI ;
Ozawa, M .
AMERICAN JOURNAL OF TRANSPLANTATION, 2004, 4 (03) :438-443