Complement-dependent cytotoxicity and Luminex technology for human leucocyte antigen antibody detection in kidney transplant candidates exposed to different sensitizing events

Katalinić, Nataša; Starčević, Alma; Mavrinac, Martina; Balen, Sanja

doi:10.1093/ckj/sfx050

Cited by 7 publications

(2 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As the clinical practice is to select for these negative T‐cell CDC crossmatches, much of this limitation cannot be avoided. We understand this limitation may have influenced the conclusions of the DSA associations with the CDC results, however, several studies have demonstrated MFI thresholds which correlate to CDC positivity 14,25–27 and the lack of sensitivity seen in CDC when compared with FXM. Here, we believe the bias toward T‐cell negative CDC did not affect the conclusions made with Luminex MFI use in predicting FXM reactivity and the benefit of using a VXM in pretransplant assessments.…”

Section: Discussionmentioning

confidence: 99%

The clinical utility and thresholds of virtual and Halifaster flow crossmatches in lung transplantation

Hiho

Levvey

Carroll

et al. 2022

HLA

View full text Add to dashboard Cite

Immune sensitization, defined as the presence of alloreactive donor‐specific antibodies (DSA), is associated with increased wait‐times and inferior transplant outcomes. Identifying pretransplant DSA with a physical cell‐based assay is critical in defining immunological risk. However, improved solid phase antibody detection has provided the potential to forgo this physical assay. Here, we evaluated the association between DSA mean fluorescence intensity (MFI) and the recently introduced Halifaster Flow cytometry crossmatch (FXM) to determine if MFI could predict the outcome of FXM and whether a virtual crossmatch (VXM) would provide an accurate risk assessment. Sera from 134 waitlisted lung patients was retrospectively assessed by Halifaster FXM against lymphocytes preparations from 32 donors, resulting in 265 FXMs. HLA typing was performed to 2‐field allelic level and Luminex single antigen beads (SAB) used to identify DSA. The association between FXM and Luminex MFI was calculated using ROC analysis. MFI threshold accuracy was confirmed using a separate validation cohort (174 recipient sera and 34 donors), whereby both VXM and FXMs were compared. From the 265 FXM performed, 48 (18%) T‐cell (TFXM) and 56 (21%) B‐cell (BFXM) were positive. In the evaluation cohort, MFI thresholds of 2000 for HLA‐A, B, DRB1, and > 4000 for DQB1, were predictive of a positive FXM. The validation cohort of 233 paired FXM and VXM confirmed these MFI thresholds for both TFXM and BFXM with an accuracy of 91.4% and 89.3%, respectively. A positive VXM, defined with HLA‐specific MFI thresholds predicts Halifaster FXM reactivity, and can potentially expedite organ allocation, by minimizing the need for the more time‐consuming FXM.

show abstract

Section: Discussionmentioning

confidence: 99%

The clinical utility and thresholds of virtual and Halifaster flow crossmatches in lung transplantation

Hiho

Levvey

Carroll

et al. 2022

HLA

View full text Add to dashboard Cite

show abstract

“…24 Pretransplant screening for the presence of anti-HLA antibodies is routine practice in patients waiting for kidney transplantation. [25][26][27] Although screening for anti-HLA antibodies has significantly decreased the incidence of hyperacute AMR, 28 it fails to identify adaptive anti-HLA specific memory T cell responses. The findings of this study support the implementation of pretransplant screening of donor-reactive memory T cells to assess the cellular immunity of individual patients and their risk to develop aTCMR.…”

Section: Discussionmentioning

confidence: 99%

Alloreactive T cells to Assess Acute Rejection Risk in Kidney Transplant Recipients

Rojas

Verhoeven

Kuiper

et al. 2023

Transplantation Direct

View full text Add to dashboard Cite

Background. Memory T cells are important mediators of transplant rejection but are not routinely measured before or after kidney transplantation. The aims of this study were as follows: (1) validate whether pretransplant donor-reactive memory T cells are reliable predictors of acute rejection (AR) (2) determine whether donor-reactive memory T cells can distinguish AR from other causes of transplant dysfunction. Methods. Samples from 103 consecutive kidney transplant recipients (2018–2019) were obtained pretransplantation and at time of for-cause biopsy sampling within 6 mo of transplantation. The number of donor-reactive interferon gamma (IFN-γ) and interleukin (IL)-21-producing memory T cells was analyzed by enzyme-linked immunosorbent spot (ELISPOT) assay. Results. Of the 63 patients who underwent a biopsy, 25 had a biopsy-proven acute rejection (BPAR; 22 aTCMR and 3 aAMR), 19 had a presumed rejection, and 19 had no rejection. Receiver operating characteristic analysis showed that the pretransplant IFN-γ ELISPOT assay distinguished between patients who later developed BPAR and patients who remained rejection-free (area under the curve [AUC] 0.73; sensitivity 96% and specificity 41%). Both the IFN-γ and IL-21 assays were able to discriminate BPAR from other causes of transplant dysfunction (AUC 0.81; sensitivity 87% and specificity 76% and AUC 0.81; sensitivity 93% and specificity 68%, respectively). Conclusions. This study validates that a high number of donor-reactive memory T cells before transplantation is associated with the development of AR after transplantation. Furthermore, it demonstrates that the IFN-γ and IL-21 ELISPOT assays are able to discriminate between patients with AR and patients without AR at the time of biopsy sampling.

show abstract

Effects of different sensitization events on HLA alloimmunization in renal transplant cases; a retrospective observation in 1066 cases

Pandey

Pande²,

Mandal³

et al. 2022

Transplant Immunology

View full text Add to dashboard Cite

Complement-dependent cytotoxicity and Luminex technology for human leucocyte antigen antibody detection in kidney transplant candidates exposed to different sensitizing events

Cited by 7 publications

References 37 publications

The clinical utility and thresholds of virtual and Halifaster flow crossmatches in lung transplantation

The clinical utility and thresholds of virtual and Halifaster flow crossmatches in lung transplantation

Alloreactive T cells to Assess Acute Rejection Risk in Kidney Transplant Recipients

Effects of different sensitization events on HLA alloimmunization in renal transplant cases; a retrospective observation in 1066 cases

Contact Info

Product

Resources

About