Catherine M Worsley1, Elizabeth S Mayne, Melinda S Suchard. 1. Department of Haematology and Molecular Medicine, University of Witwatersrand and National Health Laboratory Services, Johannesburg. catherine.worsley@nhls.ac.za
Abstract
BACKGROUND: Current practice in the Johannesburg renal transplantation programme is to perform a transplant when the patient's complement-dependent cytotoxicity and flow cytometric crossmatches are negative. However, even in patients with negative crossmatches early graft rejections have occurred. We retrospectively evaluated the use of Luminex anti-human leukocyte antigen (HLA) antibody detection technology, often termed 'virtual crossmatching', compared with the flow cytometric crossmatch, for predicting graft outcome in renal transplant patients. METHODS: Sixty-four recipients were crossmatched against multiple donors during their routine work-up for transplant (111 crossmatches); 17 of these patients received transplants during the study period. Anti-HLA antibody detection was performed using Luminex technology and the results were compared with the flow cytometric crossmatch results and with short-term graft success. RESULTS: Compared with flow cytometric crossmatch results, the sensitivity and specificity of Luminex virtual crossmatching was 85.7% and 90.7% for the T-cell crossmatch and 100% and 87.2% for the B-cell crossmatch. Both the sensitivity and specificity of Luminex for predicting short-term graft success were 100%. CONCLUSIONS: Strong evidence is provided that single-antigen assays provide improved sensitivity to detect clinically relevant anti-HLA antibodies and can reliably be used to predict short-term graft success. We recommend incorporation of single-antigen Luminex methodology into the routine work-up algorithm of renal transplant recipients in South Africa.
BACKGROUND: Current practice in the Johannesburg renal transplantation programme is to perform a transplant when the patient's complement-dependent cytotoxicity and flow cytometric crossmatches are negative. However, even in patients with negative crossmatches early graft rejections have occurred. We retrospectively evaluated the use of Luminex anti-human leukocyte antigen (HLA) antibody detection technology, often termed 'virtual crossmatching', compared with the flow cytometric crossmatch, for predicting graft outcome in renal transplant patients. METHODS: Sixty-four recipients were crossmatched against multiple donors during their routine work-up for transplant (111 crossmatches); 17 of these patients received transplants during the study period. Anti-HLA antibody detection was performed using Luminex technology and the results were compared with the flow cytometric crossmatch results and with short-term graft success. RESULTS: Compared with flow cytometric crossmatch results, the sensitivity and specificity of Luminex virtual crossmatching was 85.7% and 90.7% for the T-cell crossmatch and 100% and 87.2% for the B-cell crossmatch. Both the sensitivity and specificity of Luminex for predicting short-term graft success were 100%. CONCLUSIONS: Strong evidence is provided that single-antigen assays provide improved sensitivity to detect clinically relevant anti-HLA antibodies and can reliably be used to predict short-term graft success. We recommend incorporation of single-antigen Luminex methodology into the routine work-up algorithm of renal transplant recipients in South Africa.
Authors: N Jamshidian Tehrani; B Geramizadeh; S A Malekhosseini; S Nikeghbalian; A Bahador; S Gholami; G A Raees Jalali; J Roozbeh; M H Anbardar; N Soleimani; N Rasaei; S Mohammadzadeh Journal: Int J Organ Transplant Med Date: 2021
Authors: Ana María Arrunátegui; Daniel S Ramón; Luz Marina Viola; Linda G Olsen; Andrés Jaramillo Journal: Biomedica Date: 2022-06-01 Impact factor: 1.173