Multicenter Evaluation of the Flow Cytometry T-Cell Crossmatch

Scornik, Juan C.; Bray, Robert A.; Pollack, Marilyn S.; Cook, Daniel; Marrari, Marilyn; Duquesnoy, René J.; Langley, James W.

doi:10.1097/00007890-199705270-00013

Cited by 42 publications

(11 citation statements)

References 9 publications

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“…This, however, implicates a loss of specificity with the risk of false‐positive crossmatches. Some groups however, found a correlation between a negative FCXM and an improved graft outcome ( 10–12). Christiaans et al did not confirm this ( 13).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of anti‐human leukocyte antigen allo‐immunization in pediatric cadaveric kidney transplantation

Emonds

Herman

Dendievel

et al. 2000

Pediatric Transplantation

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Forty-eight pediatric cadaveric renal transplantations, performed between May 1986 and February 1997, were retrospectively screened, pre- and post-transplant, for antibodies to human leukocyte antigen (anti-HLA) using complement-dependent cytotoxicity (CDC) assay and enzyme immunoassay (EIA). The correlation between anti-HLA immunization and graft outcome was investigated. The combined analysis of CDC and EIA enabled the differentiation between complement-fixing and non-complement-fixing, anti-HLA class I and anti-HLA class II antibodies. The median post-transplant follow-up for all patients with a functioning graft was 86 months (range 10-138 months). In the whole population, 16 grafts were lost: six following a non-immunologic complication; and 10 as a result of rejection. Of these 10 grafts lost, eight were in patients with pre- and/or post-transplant donor antigen specific (DAS) anti-HLA class I or class I + II antibodies; and two were in patients with DAS anti-HLA class II antibodies only. Three of these grafts were lost in patients with weak pre-existing DAS anti-HLA class I antibodies. Immunological graft loss appeared at a median post-transplant time of 38 months (range 2-68 months). All patients without DAS anti-HLA antibodies had a good graft outcome. The presence of pre- and post-transplant DAS anti-HLA antibodies, especially if directed against HLA class I, were associated with a poor graft outcome. A systematic search for, and identification of, anti-HLA antibodies should therefore be part of a pretransplant evaluation to allow the identification of 'unacceptable' donor HLA antigens, following which the impact of the HLA-cross-match on graft outcome will improve. Screening for DAS anti-HLA antibodies post-transplant could be helpful for detecting patients with an increased risk for graft loss following rejection episodes.

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Section: Discussionmentioning

confidence: 99%

Evaluation of anti‐human leukocyte antigen allo‐immunization in pediatric cadaveric kidney transplantation

Emonds

Herman

Dendievel

et al. 2000

Pediatric Transplantation

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“…Acute rejection reactions generally begin in the first few weeks of transplantation, whereas chronic rejection reactions occur months to years after transplantation; as well as pre-existing DSAs, de novo DSAs produced after transplantation, are important for the graft survival. Thus, CM tests can be performed after transplantation in order to follow-up the immunological status of recipients [49,50].…”

Section: Donor Specific Antibody Detection By Flow Cytometrymentioning

confidence: 99%

“…The very first experiments on FCXM method for transplants were initiated in 1983 by Goravay. Bray [19] had significant contributions to the development of multi-colored FCXM method [50][51][52].…”

Section: Donor Specific Antibody Detection By Flow Cytometrymentioning

confidence: 99%

Detection of Anti-HLA Antibodies by Flow Cytometer

Ayna¹,

Koçyiğit²

2016

Flow Cytometry - Select Topics

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Lives of patients with solid organ failure depend physically, emotionally, and economically on others. Improvement in organ transplantation is one of the most important medical breakthroughs of the twenty-first century. "eing healthy upon organ transplantation is the second chance to live the life. This is frequently observed in heart-, lung-, and liver-transplanted patients. For instance, upon kidney transplantation, dialysis dependence terminates and life quality of the patients increases. The major difficulty in organ transplantation is the low number of organ donation. Thus, the number of patients in the waiting list for the cadaveric transplantation increases day by day. Under these limited circumstances, required conditions should be further provided for the long survival rates of recipients with allogeneic graft without any problem. Human leukocyte antigen HL" tissue typing and anti-HL" antibodies produced before and after the transplantation adversely affect the graft survival and thus the survival of an individual. Investigation of pretransplantation immune status of recipients is significant. Particularly, donor-specific anti-HL" antibodies determine early and long-term graft survival. Flow cytometer is one of the most important devices used in anti-HL" antibody detection and also for other clinical and scientific purposes. Compared to conventional methods, it supports transplantation clinics due to its high sensitivity and specificity. The use of flow cytometer dependent methods in transplantation field increases progressively.

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“…Despite improved sensitivity over direct CDC, between-center variation is an important problem for both indirect CDC and FCXM that limits sharing and clinical studies between centers[18]. Pretest factors associated with a donor’s medical care can affect test results by changing the number, viability and levels of HLA antigen expression on separated lymphocytes[19].…”

Section: Evolution Of Testingmentioning

confidence: 99%

Transplant immuno-diagnostics: crossmatch and antigen detection

South

Grimm

2015

Pediatr Nephrol

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Identifying and monitoring donor-directed anti-human leukocyte antigen antibodies are a rapidly evolving area of solid organ transplantation. Donor-specific antibodies dictate pre-transplant donor choice and donor-recipient matching and underlie much acute and chronic allograft rejection and loss. The evolution of available technology has driven this progress. Early, labor intensive, whole-cell assays based on complement-dependent cytotoxicity suffered from poor sensitivity and specificity, technical challenges and lack of precision. Sequential improvement in assay performance included antihuman immunoglobulin-enhanced complement-dependent cytotoxicity techniques followed by cell-based flow cytometry. However, variable specificity and sensitivity inherent in cell-based testing continued to limit flow cytometry. The introduction of solid-phase assays led to a second revolution in histocompatibility testing with the use of purified antigens bound to artificial surfaces rather than whole cells. These techniques augmented sensitivity and specificity to detect even low-titer antibodies to previously undetected antigens. Identification of complement-activating antibodies is being introduced but current technology is in the developmental stage. While detection of alloantibodies has improved dramatically, our comprehension of their importance remains imperfect. Variability in methodology and a lack of standardization limits the clinical application of these tests. In spite of the hurdles that remain, antibody-mediated rejection has become a key target to improve graft survival.

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Multicenter Evaluation of the Flow Cytometry T-Cell Crossmatch

Abstract: Flow cytometry, as used by most centers, is highly sensitive and allows relative antibody quantitation. Furthermore, the data define objective parameters that may help to standardize the test and improve its predictive value in clinical transplantation.

Cited by 42 publications

References 9 publications

Evaluation of anti‐human leukocyte antigen allo‐immunization in pediatric cadaveric kidney transplantation

Evaluation of anti‐human leukocyte antigen allo‐immunization in pediatric cadaveric kidney transplantation

Detection of Anti-HLA Antibodies by Flow Cytometer

Transplant immuno-diagnostics: crossmatch and antigen detection

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