<i>In vivo</i> Heat Inactivation of Serum can Distinguish False Positive Cross Matches in Renal Transplants

Riley, Alyssa A.; Klingman, L.; Brier, Michael E.; Chand, Deepa H.

doi:10.5301/ijao.5000470

Cited by 5 publications

(5 citation statements)

References 15 publications

(21 reference statements)

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“…The full-text review was undertaken for 886 eligible articles; of these 78 articles discussed HLA incompatibility at the level of the antigen mismatch only, 64-141 whereas 163 articles assessed incompatibility by molecular genotyping, molecular mismatch analysis, and/or pretransplant DSA verification by solid-phase and/or by cell-based assays. 3,142-303 The Preferred Reporting Items for Systematic reviews and Meta-Analyses diagram outlining the article selection process is provided in Figure 1. 304…”

Section: Resultsmentioning

confidence: 99%

Seeking Standardized Definitions for HLA-incompatible Kidney Transplants: A Systematic Review

et al. 2022

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Original Clinical Science-GeneralBackground. There is no standard definition for "HLA incompatible" transplants. For the first time, we systematically assessed how HLA incompatibility was defined in contemporary peer-reviewed publications and its prognostic implication to transplant outcomes. Methods. We combined 2 independent searches of MEDLINE, EMBASE, and the Cochrane Library from 2015 to 2019. Content-expert reviewers screened for original research on outcomes of HLA-incompatible transplants (defined as allele or molecular mismatch and solid-phase or cell-based assays). We ascertained the completeness of reporting on a predefined set of variables assessing HLA incompatibility, therapies, and outcomes. Given significant heterogeneity, we conducted narrative synthesis and assessed risk of bias in studies examining the association between death-censored graft failure and HLA incompatibility. Results. Of 6656 screened articles, 163 evaluated transplant outcomes by HLA incompatibility. Most articles reported on cytotoxic/flow T-cell crossmatches (n = 98). Molecular genotypes were reported for selected loci at the allele-group level. Sixteen articles reported on epitope compatibility. Pretransplant donor-specific HLA antibodies were often considered (n = 143); yet there was heterogeneity in sample handling, assay procedure, and incomplete reporting on donor-specific HLA antibodies assignment. Induction (n = 129) and maintenance immunosuppression (n = 140) were frequently mentioned but less so rejection treatment (n = 72) and desensitization (n = 70). Studies assessing death-censored graft failure risk by HLA incompatibility were vulnerable to bias in the participant, predictor, and analysis domains. Conclusions. Optimization of transplant outcomes and personalized care depends on accurate HLA compatibility assessment. Reporting on a standard set of variables will help assess generalizability of research, allow knowledge synthesis, and facilitate international collaboration in clinical trials.

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Section: Resultsmentioning

confidence: 99%

Seeking Standardized Definitions for HLA-incompatible Kidney Transplants: A Systematic Review

et al. 2022

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“…The technique of heating plasma in order to inactivate IgM antibodies was first described in 1981 by Steinberg and Cook [30]. Studies performed previously for pretransplant work-up of solid organ transplant recipients have concluded that presence of IgM antibodies can cause false positive CDC crossmatch and subsequent use of heat inactivation technique can eliminate this false positivity by decreasing interference of IgM antibodies [31,32]. However, the effect of heat inactivation on the ABO isohemagglutinin titers have not been studied in detail when compared to study of the effect of DTT or 2-ME on ABO titers.…”

Section: Discussionmentioning

confidence: 99%

“…Hasekura, et al heated sera at 70 °C for 10 minutes and observed a significant decline in both IgM and IgG titers of anti-A and anti-B titers [33]. Riley, et al heated plasma at 63 °C for 10 minutes to ameliorate the effect of IgM in false positive CDC crossmatch [32]. In the present study, HI was performed at 63 °C for 13 minutes as per ASHI laboratory manual [29].…”

Section: Discussionmentioning

confidence: 99%

A Prospective Observational Study to Compare Heat Inactivated ABO Isoagglutinin Titres Performed by CTT and CAT with Solid Phase Red Cell Adhesion (SPRCA) in O Blood Group Individuals

Shweta¹,

Prashant²,

Divya³

et al. 2022

Int J Blood Res Disord

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Background and aims: Measurement of actual concentration of IgG requires methods like heat inactivation (HI) of plasma. This study was aimed at comparing of heat treated ABO titers performed by conventional test tube technique (CTT) and column agglutination technique (CAT) with HA/SPRCA. Materials and methods:This was a prospective, observational study conducted from October 2018 to March 2020. All consecutive O group donors who gave consent for participation were included. All samples were tested by CTT and CAT before and after HI (pCTT, pCAT) and with HA/SPRCA.Results: A total of 2005 donors were included. IgG titers were found to be more than IgM titers. PCTT IgG results are similar or lower when compared to results obtained by SPRCA, while pCAT IgG titers were higher with pCAT when compared to HA/SPRCA. Results of titers obtained by pCTT were lower as compared to pCAT and HA/SPRCA, with majority giving results less than 64. Median IgG and IgM titers for both anti-A and anti-B were highest in pCAT, while median IgG and IgM anti-A and anti-B titers were similar with HA and pCTT. Conclusion:Results obtained by HA/SPRCA were closer to results obtained by pCTT, with the advantage of less time consumption, automation requiring less expertise and no inter-observer variation. Titers obtained by pCAT were higher in comparison to HA/SPRCA and pCTT results, due to high sensitivity.

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“…The technique of heating the serum in order to remove IgM antibodies activity was first mentioned in 1981 by Steinberg and Cook [28]. A few studies have shown the effectiveness of HI in eliminating IgM activity, resulting in negative complement‐dependent cytotoxicity (CDC)‐based crossmatch results in cases of solid organ transplant, in those cases previously found to be crossmatch false positive [29,30]. However, the effect of heat on the ABO isohemagglutinin titres have not been studied as compared to DTT or 2‐ME.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, Riley et al. heated serum at 63°C for 10 min to ameliorate the effect of IgM in false‐positive CDC crossmatch [30]. In the present study, heat inactivation was performed at 63°C for 13 min in accordance with the ASHI [27].…”

Section: Discussionmentioning

confidence: 99%

A prospective, observational study to compare effect of DTT treatment and heat inactivation on ABO isoagglutinin titers in O blood group donors

Pandey

Setya

Ranjan

et al. 2021

ISBT Science Series

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Background and aims In order to determine actual concentration of clinically significant IgG antibodies, there is a need to inactivate IgM antibodies, which can be performed by DTT or heat. The aim of the present study was to compare the effect of DTT treatment and heat inactivation (HI) on ABO isoagglutinin titres performed by column agglutination technology (CAT) and conventional tube technique (CTT). Materials and methods This was a prospective, observational study conducted from October 2018 to March 2020. All consecutive O group donors were included. Serum from each donor was treated with DTT, and heat and tests were performed by CTT and CAT before and after treatment. Results A total of 2005 donors were included. 401 (20%) samples had inter‐observer variation by CTT, and 69 (3·4%) had inter‐observer variation by CAT. Median anti‐A and anti‐B titre results were higher with CAT as compared to CTT. Median anti‐A and anti‐B IgG titre results showed a one‐ to twofold difference between CTT and CAT with higher titres reported by CAT. Median IgM titres decreased two‐ to threefold after DTT treatment, whereas onefold decrease was confirmed after HI. Concordance was found to be poor. However, correlation was found to be strong. Conclusion There is overestimation of ABO IgG antibody titres and hence, estimation of ABO IgG titres after inactivation of IgM antibodies is strongly recommended. DTT treatment was found to be superior to HI in terms of efficiency in elimination of IgM activity.

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In vivo Heat Inactivation of Serum can Distinguish False Positive Cross Matches in Renal Transplants

Cited by 5 publications

References 15 publications

Seeking Standardized Definitions for HLA-incompatible Kidney Transplants: A Systematic Review

Seeking Standardized Definitions for HLA-incompatible Kidney Transplants: A Systematic Review

A Prospective Observational Study to Compare Heat Inactivated ABO Isoagglutinin Titres Performed by CTT and CAT with Solid Phase Red Cell Adhesion (SPRCA) in O Blood Group Individuals

A prospective, observational study to compare effect of DTT treatment and heat inactivation on ABO isoagglutinin titers in O blood group donors

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