Flow cytometry beads rather than the antihuman globulin method should be used to detect HLA Class I IgG antibody (PRA) in cadaveric renal regraft candidates

被引:7
作者
Bryan, CF [1 ]
McDonald, SB [1 ]
Baier, KA [1 ]
Luger, AM [1 ]
Aeder, MI [1 ]
Murillo, D [1 ]
Muruve, NA [1 ]
Nelson, PW [1 ]
Shield, CF [1 ]
Warady, BA [1 ]
机构
[1] Midwest Transplant Network, Westwood, KS 66205 USA
关键词
Class IPRA; flow PRA; regrafts; renal;
D O I
10.1034/j.1399-0012.16.s7.2.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
HLA Class I antibody screening can be performed by flow cytometry using a mixture of 30 distinct bead populations each coated with the Class I antigen phenotype derived from different cell lines. In this study we compared the efficacy of Class I antibody screens done by flow cytometry beads with the antihuman globulin (AHG) method for patients awaiting cadaveric renal retransplantation. Class I panel reactive antibody (PRA) screening by flow cytometric beads of 21 regraft serum samples that had all been found to be negative by AHG DTT Class I PRA, revealed that 57.1% (12 of 21) had a flow Class I PRA of greater than or equal to 10%. Furthermore, when five regraft sera with an intermediate PRA were screened (mean AHG DTT PRA = 33.2 +/- 13%) the mean flow Class I PRA almost doubled (mean flow PRA = 72.4 +/- 10.2%) ( p < 0.01). When active UNOS waiting list regraft candidates, after several months of screening the Class I PRA by flow beads, were divided into the three PRA categories based on their peak flow Class I PRA value (0-20%, 21-79% and ≥ 80%), the incidence of a positive flow cross-match was 0%, 72% and 85% and the incidence of retransplantation was 60%, 22% and 10%, in each of these groups, respectively. These data provided our histocompatibility laboratory with the rationale to stop performing the AHG PRA and perform only the flow Class I PRA method for regraft candidates.
引用
收藏
页码:15 / 23
页数:9
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