Impact of Different Levels of Preformed Anti-HLA Donor Specific Antibodies Detected by Single Antigen Luminex Assay on Kidney Transplants Performed with Negative Complement Dependent Cytotoxicity T and B Crossmatches

The aim of the present study was to describe the association of positive flow cross match (FXM) and C1q-SAB.Methods. In this observational, cross-sectional, and comparative study, patients included had negative AHG-CDC-XM and donor specific antibodies (DSA) and were tested with FXM. All pretransplant sera were tested with C1q-SAB assay.Results. A total of 50 donor/recipient evaluations were conducted; half of them had at least one C1q+ Ab (n=26, 52%). Ten patients (20.0%) had DSA C1q+ Ab. Twenty-five (50%) FXMs were positive. Factors associated with a positive FXM were the presence of C1q+ Ab (DSA C1q+ Ab: OR 27, 2.80–259.56,P=0.004, and no DSA C1q+ Ab: OR 5, 1.27–19.68,P=0.021) and the DSA LABScreen-SAB MFI (OR 1.26, 95% CI 1.06–1.49,P=0.007). The cutoff point of immunodominant LABScreen SAB DSA-MFI with the greatest sensitivity and specificity to predict FXM was 2,300 (sensitivity: 72% and specificity: 75%). For FXM prediction, DSA C1q+ Ab was the most specific (95.8%, 85–100) and the combination of DSA-MFI > 2,300 and C1q+ Ab was the most sensitive (92.0%, 79.3–100).Conclusions. C1q+ Ab and LABScreen SAB DSA-MFI were significantly associated with FXM. DSA C1q+ Ab was highly specific but with low sensitivity.

Download Full-text

Clinical relevance of HLA donor-specific antibodies detected by single antigen assay in kidney transplantation

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfr429 ◽

2011 ◽

Vol 27 (3) ◽

pp. 1231-1238 ◽

Cited By ~ 74

Author(s):

J. L. Caro-Oleas ◽

M. F. Gonzalez-Escribano ◽

F. M. Gonzalez-Roncero ◽

M. J. Acevedo-Calado ◽

V. Cabello-Chaves ◽

...

Keyword(s):

Kidney Transplantation ◽

Clinical Relevance ◽

Specific Antibodies ◽

Antigen Assay ◽

Single Antigen ◽

Donor Specific Antibodies

Download Full-text

Intensity of de novo DSA detected by Immucor Lifecodes assay and C3d fixing antibodies are not predictive of subclinical ABMR after Kidney Transplantation

PLoS ONE ◽

10.1371/journal.pone.0249934 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249934

Author(s):

Dominique Bertrand ◽

Rangolie Kaveri ◽

Charlotte Laurent ◽

Philippe Gatault ◽

Maïté Jauréguy ◽

...

Keyword(s):

Kidney Transplantation ◽

Prognostic Value ◽

De Novo ◽

Added Value ◽

Multicentric Study ◽

Specific Antibodies ◽

Antibody Mediated Rejection ◽

Single Antigen ◽

Donor Specific Antibodies ◽

Allograft Loss

De novo donor-specific antibodies (dnDSA) are associated with antibody-mediated rejection (ABMR) and allograft loss. We tested Immucor* (IM) Luminex Single-antigen beads (LSAB) assay and C3d-fixing antibodies in the setting of dnDSA and subclinical (s) ABMR. This retrospective multicentric study included 123 patients biopsied because of the presence of subclinical de novo DSA detected by One Lamda* Labscreen (MFI > 1000). In 112 patients, sera of the day of the biopsy were available and tested in a central lab with IM Lifecodes LSAB and C3d fixing antibodies assays. In 16 patients (14.3%), no DSA was detected using Immucor test. In 96 patients, at least one DSA was determined with IM. Systematic biopsies showed active sABMR in 30 patients (31.2%), chronic active sABMR in 17 patients (17.7%) and no lesions of sABMR in 49 KT recipients (51%). Intensitity criteria (BCM, BCR and AD-BCR) of DSA were not statistically different between these 3 histological groups. The proportion of patients with C3d-fixing DSA was not statistically different between the 3 groups and did not offer any prognostic value regarding graft survival. Performing biopsy for dnDSA could not be guided by the intensity criteria of IM LSAB assay. C3d-fixing DSA do not offer added value.

Download Full-text