Successful Renal Transplantation Despite a Positive Fluorescence-Activated Cell Sorter Crossmatch Following Plasma Exchange of Donor-Specific Anti-Hla Antibodies

Mj, Raftery; Malik, Susanta; Tidman, N; Jánossy, G.; Sweny, P.; Fernando, O. N.; Moorheàd, J. F.

doi:10.1097/00007890-198601000-00030

Cited by 7 publications

(3 citation statements)

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“…However, despite an undeniable in crease in sensitivity compared to standard light micros copy [15], it has become clear that the antibodies detected by such assays did not have the same cytotoxic activity as those revealed by the standard technique. The clinical consequences of this diversity have been reported [10,11,16,17]: a pretransplant positive CM performed by the FC techniques already described identifies a population of transplant recipients with a high risk of graft loss due to immunological events (acute rejection), but in many pa tients the antibodies detected are irrelevant to transplant outcome.…”

Section: Discussionmentioning

confidence: 99%

Validity of Flow Cytometry for Cross-Match Evaluation in Clinical Renal Transplantation

Stefoni

Nanni-Costa²,

Buscaroli³

et al. 1991

Nephron

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This paper reports a 2-year experience of more than 5,000 cross-match tests for renal transplantation. Tests were performed by means of both standard light microscopy and an innovatory method based on now cytometry, an up-to-date investigative technique for computerized analysis of individual cell characteristics. Flow cytometry allowed a better detection of weak positive reactions (false-negative cross-matches) than light microscopy, thus reducing the risk of selecting candidates with donor presensitization. Transplant clinical outcome supported the value of this original and advanced technological method.

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Section: Discussionmentioning

confidence: 99%

Validity of Flow Cytometry for Cross-Match Evaluation in Clinical Renal Transplantation

Stefoni

Nanni-Costa²,

Buscaroli³

et al. 1991

Nephron

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“…It would be easy to deny transplants to recipients with any DSA, at least detectable antibody, but how do we know we are not denying someone access to transplantation unfairly? A review of the literature will show that even some patients with a positive cross‐match, determined by primitive means, were nevertheless transplanted and are doing well today (Ettinger et al ., 1976; Goeken, 1985; Rosenthal et al ., 1985; Raftery et al ., 1986; Barger et al ., 1989). While not all antibodies are bad, the difficulty is in being able to predict which will be clinically relevant and which will not (Delmonico et al ., 1983; Oldfather et al ., 1986; Gebel & Bray, 2000; Gebel et al ., 2003; Bray et al ., 2006).…”

Section: Introductionmentioning

confidence: 99%

Solid phase testing in the HLA laboratory: implications for organ allocation

Eckels

2008

Int J Immunogenetics

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This piece was originally requested as a white paper from the Scientific and Clinical Affairs Committee of the American Society for Histocompatibility and Immunogenetics (ASHI), of which the author was then Chairman. Upon review by the ASHI Board of Directors and the Editors of their journal, it was considered too controversial for publication. It is intended to be provocative and controversial; it is not intended as a review of the literature. Though written with a decided 'American point of view', it is of importance that the issues facing US transplantation and laboratory testing efforts are shared to varying degrees by the international community, and who, unlike some of their American cousins, may be able to tolerate a spirited discussion. Sadly, we sometimes forget that dissent from dogma can be fun!

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“…They thus represent a different approach to the problem, being able to identify populations of transplant recip ients with a high risk of graft loss due to immunological events. In some patients, however, the antibodies detected have proved to be irrelevant to the transplantation out come [5].…”

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confidence: 99%