Moshe Israeli1, Marilyn S Pollack2, Carley A E Shaut3, Anne Halpin4, Nicholas R DiPaola5, Danny Youngs6, Susan L Saidman7. 1. Tissue Typing Laboratory, Rabin Medical Center, Beilinson Campus, Zabotinski Road, Petach-Tikva 49100, Israel; Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: israelimoshe@yahoo.com. 2. Department of Pathology, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA. 3. School of Medicine, Oregon Health & Science University, 2611 SW 3rd Ave Suite 360, Portland, OR 97239, USA. 4. Histocompatibility Laboratory, University of Alberta Hospital, 8220-112 St, Edmonton, AB T6G 2B7, Canada. 5. Clinical Histocompatibility Lab, Wexner Medical Center, The Ohio State University, N943 Doan Hall, 410 W 10th Avenue, Columbus, OH 43210, USA. 6. Puget Sound Blood Center, 921 Terry Ave., Seattle, WA 98104, USA. 7. Histocompatibility Laboratory, Massachusetts General Hospital, 55 Fruit St, Room GRJ 220, Boston, MA 02114, USA.
Abstract
BACKGROUND: Correct identification of the specificity of antibodies directed against HLA using single antigen Luminex beads (SALB) is essential in current HLA laboratory practice for transplantation. The aim of this study was to investigate the magnitude of concordance and discordance among laboratories in testing for anti-HLA antibodies using SALB. METHOD: 35 sera were distributed by the ASHI Proficiency Testing Program to HLA laboratories worldwide. We analyzed 4335 test results submitted between April 2010 and April 2013 by participating laboratories. RESULTS: SALB was used by approximately 94% of the participating laboratories, yet concordant assignment of antibody specificity was imperfect. For each serum, the assignment of an average of 10 antibody specificities was discordant. Disagreement was observed for antibodies directed against common as well as uncommon antigens. The assignment of an average of 15 antibody specificities in each "positive" serum appeared to be influenced by vendor-dependent causes. Inter-vendor concordance was lower than intra-vendor concordance, indicating that vendor dependent factors may be a central cause for disagreement. CONCLUSIONS: Our study illustrates the prevalence of concordance and discordance, also affected by unpremeditated causes, in reporting SALB antibody results. Insufficient concordance and standardization in antibody testing may have practical implications for organ allocation and organ sharing programs.
BACKGROUND: Correct identification of the specificity of antibodies directed against HLA using single antigen Luminex beads (SALB) is essential in current HLA laboratory practice for transplantation. The aim of this study was to investigate the magnitude of concordance and discordance among laboratories in testing for anti-HLA antibodies using SALB. METHOD: 35 sera were distributed by the ASHI Proficiency Testing Program to HLA laboratories worldwide. We analyzed 4335 test results submitted between April 2010 and April 2013 by participating laboratories. RESULTS: SALB was used by approximately 94% of the participating laboratories, yet concordant assignment of antibody specificity was imperfect. For each serum, the assignment of an average of 10 antibody specificities was discordant. Disagreement was observed for antibodies directed against common as well as uncommon antigens. The assignment of an average of 15 antibody specificities in each "positive" serum appeared to be influenced by vendor-dependent causes. Inter-vendor concordance was lower than intra-vendor concordance, indicating that vendor dependent factors may be a central cause for disagreement. CONCLUSIONS: Our study illustrates the prevalence of concordance and discordance, also affected by unpremeditated causes, in reporting SALB antibody results. Insufficient concordance and standardization in antibody testing may have practical implications for organ allocation and organ sharing programs.
Authors: Kevin J Clerkin; Sarah B See; Maryjane A Farr; Susan W Restaino; Geo Serban; Farhana Latif; Lingzhi Li; Paolo C Colombo; George Vlad; Bryan Ray; Elena R Vasilescu; Emmanuel Zorn Journal: Transplant Direct Date: 2017-10-02
Authors: Helena Car; Gonca E Karahan; Geertje J Dreyer; Simone H Brand-Schaaf; Aiko P J de Vries; Cees van Kooten; Cynthia S M Kramer; Dave L Roelen; Frans H J Claas; Sebastiaan Heidt Journal: HLA Date: 2020-12-02 Impact factor: 4.513