Role of crossmatch testing when Luminex-SAB is negative in renal transplantation

2018 ◽  
Vol 90 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Kumar Jayant ◽  
Isabella Reccia ◽  
Bridson M Julie ◽  
Ajay Sharma ◽  
Ahmed Halawa
Keyword(s):  
Solid Phase ◽  
Human Leukocyte ◽  
Hla Typing ◽  
Antibody Detection ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Detection Techniques ◽  
Leukocyte Antigen ◽  
Hla Antibody

The human leukocyte antigen (HLA) system plays an important role in the acceptance of renal graft. Long and better graft survival has been reported in patients with HLA-identical siblings and a nonreactive cytotoxicity assay (CDC). New methods of HLA-typing and anti-HLA antibody detection techniques such as flow cytometry, solid-phase immunoassays, or antigen bead assays have further improved the outcomes of renal transplant recipients. In the present review, the explicit details of these methodologies are discussed in detail.

scholarly journals Antibody-Mediated Rejection: Pathogenesis, Prevention, Treatment, and Outcomes

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Olivia R. Blume ◽  
Sarah E. Yost ◽  
Bruce Kaplan
Keyword(s):  
Plasma Cells ◽  
Graft Function ◽  
Human Leukocyte ◽  
Hla Typing ◽  
Antibody Detection ◽  
Peritubular Capillary ◽  
Leukocyte Antigen ◽  
Antibody Mediated Rejection ◽  
Transplant Failure

Antibody-mediated rejection (AMR) is a major cause of late kidney transplant failure. It is important to have an understanding of human-leukocyte antigen (HLA) typing including well-designed studies to determine anti-MHC-class-I-related chain A (MICA) and antibody rejection pathogenesis. This can allow for more specific diagnosis and treatment which may improve long-term graft function. HLA-specific antibody detection prior to transplantation allows one to help determine the risk for AMR while detection of DSA along with a biopsy confirms it. It is now appreciated that biopsy for AMR does not have to include diffuse C4d, but does require a closer look at peritubular capillary microvasculature. Although plasmapheresis (PP) is effective in removing alloantibodies (DSAs) from the circulation, rebound synthesis of alloantibodies can occur. Splenectomy is used in desensitization protocols for ABO incompatible transplants as well as being found to treat AMR refractory to conventional treatment. Also used are agents targeted for plasma cells, B cells, and the complement cascade which are bortezomib rituximab and eculizumab, respectively.

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