Comparison Between Phenotypic Bead Assay and Single Antigen Bead Assay for Determining Specificity of HLA Antibodies in Kidney Transplant Waiting List

2020 ◽  
Vol 52 (6) ◽  
pp. 1675-1679
Author(s):  
Duangtawan Thammanichanond ◽  
Sireewan Sukhumvat ◽  
Chutima Tammakorn ◽  
Sukanya Siriyotha ◽  
Surasak Kantachuvesiri
Keyword(s):  
Kidney Transplant ◽  
Waiting List ◽  
Hla Antibodies ◽  
Single Antigen

Pretransplant Single Antigen Bead–Detected HLA Antibodies in Kidney Transplant Long-term Outcome: A Single-Center Cohort Experience

2019 ◽  
Vol 51 (3) ◽  
pp. 707-714
Author(s):  
S.M. Passamonti ◽  
A. Cannavò ◽  
A. Espadas de Arias ◽  
A. Innocente ◽  
M. Ramondetta ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Single Center ◽  
Term Outcome ◽  
Hla Antibodies ◽  
Long Term Outcome ◽  
Single Antigen

scholarly journals P1604SIGNIFICANT DETECTION OF UNEXPLAINED HLA ANTIBODIES WITH SINGLE-ANTIGEN BEADS IN PATIENTS ON THE WAITING-LIST WITHOUT PREVIOUS SENSITIZING EVENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sara Núñez Delgado ◽  
Carla Burballa Tarrega ◽  
José Luis Caro ◽  
Carlos Arias Cabrales ◽  
Marisa Mir Fontana ◽  
...  
Keyword(s):  
Solid Phase ◽  
Class Ii ◽  
Automated Detection ◽  
Waiting List ◽  
Hla Antigen ◽  
Hla Antibodies ◽  
Single Antigen ◽  
Screening Assays ◽  
As Solid Phase ◽  
Limit Access

Abstract Background and Aims The introduction of more sensitive and specific tools as solid phase immunoasssays has improved the ability to detect HLA antibodies. The techniques based on solid phase immunoassays in Luminex system can be performed either as screening assays (with pooled antigen panels that use bead populations coated in affinity-purified class I or class II HLA molecules) or to assess the specificity with single-antigen bead (SAB) assays (single cloned allelic HLA antigen).The sensitivity of each assay Is different, and their results may be discordant. Our objective was to evaluate the potential discrepancies between tests in a cohort of patients on our waiting list with no previous sensitizing events, for their potential influence in the access to transplantation. Method Observational study of 184 patients included in the kidney-transplant waiting list on March 31st, 2019. All possible sensitizing events (pregnancy, transfusion and previous transplants) were registered. HLA antibodies where analyzed both by screening and SAB tests. Results We limited the observations to males (64.7% of the cohort), as most women (95.4%) had a known sensitizing event, not being possible to discard possible pregnancies in the remaining. Of men, 46.2% had a sensitizing event and 63.8% did not. All 63 unsensitized patients showed a negative screening test, and 49 (77,78%) had at least one SAB done being positive in 73.4% (36/49). The positive SAB yielded a cPRA >10% in 30 cases (between 21-85%), mostly (27/30) due to HLA class II antibodies (88.8% with at least one DQ antibody) with a median MFI of 1571 (range:752-17650). A thorough review of specificities showed that 81% DQB1* and 89.6% DQA1* antibodies did not show consistency in all beads included for the same allele. Conclusion Screening and SAB assays show a significant discordancy in unsensitized men included in the waiting list for kidney transplantation. Automated detection of antibodies by SAB without a proper specialized interpretation may wrongly limit access to transplantation.

scholarly journals Pretransplant Kinetics of Anti-HLA Antibodies in Patients on the Waiting List for Kidney Transplantation

2019 ◽  
Vol 30 (11) ◽  
pp. 2262-2274 ◽  
Author(s):  
Matteo Togninalli ◽  
Daisuke Yoneoka ◽  
Antonios G.A. Kolios ◽  
Karsten Borgwardt ◽  
Jakob Nilsson
Keyword(s):  
Kidney Transplant ◽  
Organ Transplant ◽  
Hla Antigens ◽  
Waiting Lists ◽  
Individual Variability ◽  
Waiting List ◽  
University Hospital ◽  
Time Interval ◽  
Hla Antibodies ◽  
Apparent Lack

BackgroundPatients on organ transplant waiting lists are evaluated for preexisting alloimmunity to minimize episodes of acute and chronic rejection by regularly monitoring for changes in alloimmune status. There are few studies on how alloimmunity changes over time in patients on kidney allograft waiting lists, and an apparent lack of research-based evidence supporting currently used monitoring intervals.MethodsTo investigate the dynamics of alloimmune responses directed at HLA antigens, we retrospectively evaluated data on anti-HLA antibodies measured by the single-antigen bead assay from 627 waitlisted patients who subsequently received a kidney transplant at University Hospital Zurich, Switzerland, between 2008 and 2017. Our analysis focused on a filtered dataset comprising 467 patients who had at least two assay measurements.ResultsWithin the filtered dataset, we analyzed potential changes in mean fluorescence intensity values (reflecting bound anti-HLA antibodies) between consecutive measurements for individual patients in relation to the time interval between measurements. Using multiple approaches, we found no correlation between these two factors. However, when we stratified the dataset on the basis of documented previous immunizing events (transplant, pregnancy, or transfusion), we found significant differences in the magnitude of change in alloimmune status, especially among patients with a previous transplant versus patients without such a history. Further efforts to cluster patients according to statistical properties related to alloimmune status kinetics were unsuccessful, indicating considerable complexity in individual variability.ConclusionsAlloimmune kinetics in patients on a kidney transplant waiting list do not appear to be related to the interval between measurements, but are instead associated with alloimmunization history. This suggests that an individualized strategy for alloimmune status monitoring may be preferable to currently used intervals.

Racial Differences in Access to the Kidney Transplant Waiting List for Children and Adolescents With End-Stage Renal Disease

PEDIATRICS ◽  
2000 ◽  
Vol 106 (4) ◽  
pp. 756-761 ◽  
Author(s):  
S. L. Furth ◽  
P. P. Garg ◽  
A. M. Neu ◽  
W. Hwang ◽  
B. A. Fivush ◽  
...  
Keyword(s):  
Renal Disease ◽  
Children And Adolescents ◽  
Kidney Transplant ◽  
Racial Differences ◽  
End Stage Renal Disease ◽  
Waiting List ◽  
Stage Renal Disease ◽  
End Stage

P101 Development of C1Q binding donor specific anti-HLA antibodies in pediatric kidney transplant recipients

2017 ◽  
Vol 78 ◽  
pp. 127
Author(s):  
Adriana I. Colovai ◽  
Christina Savchik ◽  
Dianne Ramkishun ◽  
Sonia Solomon ◽  
Enver Akalin ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Hla Antibodies

scholarly journals The determinants, biomarkers, and consequences of microvascular injury in kidney transplant recipients

2019 ◽  
Vol 316 (1) ◽  
pp. F9-F19 ◽  
Author(s):  
Alice Doreille ◽  
Mélanie Dieudé ◽  
Heloise Cardinal
Keyword(s):  
Kidney Disease ◽  
Kidney Transplant ◽  
Interstitial Fibrosis ◽  
Ischemia Reperfusion ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Hla Antibodies ◽  
Microvascular Injury ◽  
Antibody Mediated Rejection ◽  
Peritubular Capillaries

Independent of the initial cause of kidney disease, microvascular injury to the peritubular capillary network appears to play a central role in the development of interstitial fibrosis in both native and transplanted kidney disease. This association is explained by mechanisms such as the upregulation of profibrotic genes and epigenetic changes induced by hypoxia, capillary leakage, endothelial and pericyte transition to interstitial fibroblasts, as well as modifications in the secretome of endothelial cells. Alloimmune injury due to antibody-mediated rejection and ischemia-reperfusion injury are the two main etiologies of microvascular damage in kidney transplant recipients. The presence of circulating donor-specific anti-human leukocyte antigen (HLA) antibodies, histological findings, such as diffuse C4d staining in peritubular capillaries, and the extent and severity of peritubular capillaritis, are commonly used clinically to provide both diagnostic and prognostic information. Complement-dependent assays, circulating non-HLA antibodies, or evaluation of the microvasculature with novel imaging techniques are the subject of ongoing studies.

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