The Relevance of a More Sensitive Crossmatch Assay to Renal Transplantation

Talbot, David; Givan, Alice L.; Shenton, B. K.; Stratton, Ann; Proud, G.; Taylor, Robert M.

doi:10.1097/00007890-198903000-00030

Cited by 56 publications

(23 citation statements)

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“…Flow cytometry is more sensitive than CDC and enables detection of antibody levels of all IgG isotypes (both complement fixing and non-complement fixing) that are not apparent by CDC but nevertheless are associated with an increased risk of renal allograft rejection and graft loss during the first year [11][12][13][14][15]. Like the CDC cross-match, the flow cytometric crossmatch (FCXM) test sometimes lacks specificity, so unless it is used selectively, patients may be unnecessarily denied transplantation based on a positive result [16].…”

Section: Flow Cytometrymentioning

confidence: 99%

Back to the future: application of contemporary technology to long-standing questions about the clinical relevance of human leukocyte antigen-specific alloantibodies in renal transplantation

et al. 2009

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Section: Flow Cytometrymentioning

confidence: 99%

Back to the future: application of contemporary technology to long-standing questions about the clinical relevance of human leukocyte antigen-specific alloantibodies in renal transplantation

et al. 2009

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“…Patients awaiting renal transplantation are routinely tested for lymphocytotoxic panel-reactive antibodies (PRA), and graft allocation depends on the current T-and B-cell complement-dependent cytotoxicity (CDC) crossmatches. Much effort has been spent on increasing the sensitivity of the crossmatch assay such that weak anti-HLA sensitization can be detected (2,3), and new techniques for pretransplant antibody testing based on highly sensitive, strictly HLA-specific ELISAs have been developed (4,5). But up to now, no study has permitted evaluation of the clinical impact of donor-specific antibodies against HLA antigens (DSA) identified before transplantation by sensitive techniques.…”

Section: Introductionmentioning

confidence: 99%

Clinical Relevance of Preformed HLA Donor-Specific Antibodies in Kidney Transplantation

Lefaucheur¹,

Suberbielle-Boissel

Hill

et al. 2008

American Journal of Transplantation

208

104

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This study analyzes the influence of preformed DSA, identified by HLA-specific ELISA assays, on graft survival and evaluates the incidence of antibodymediated rejection (AMR) in patients with and without pregraft desensitization.Kidney graft survival at 8 years was significantly worse in patients with DSA (n = 43) than in those without DSA (n = 194)(p = 0.03). The incidence of AMR in patients with DSA is 9-fold higher than in patients without DSA (p < 0.001) and their graft survival is significantly worse than in DSA patients without AMR and in non-DSA patients (p = 0.005). The prevalence for AMR in patients with DSA detected on historic serum is 32.3% in nondesensitized patients and 41.7% in desensitized patients. The risk for AMR is significantly more elevated in patients with strongly positive DSA (score 6-8) compared to those with DSA score 4 (p < 0.001), and in patients with historic DSA+/CXM+ compared to those with DSA+/CXM− (p = 0.01).The presence of preformed DSA is strongly associated with graft loss in kidney transplants, related to an increased risk of AMR. Our findings demonstrate the importance of detection and characterization of DSA before transplantation. Stratification of this risk could be used to determine kidney allocation and to devise specific strategies for these patients.

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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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The Relevance of a More Sensitive Crossmatch Assay to Renal Transplantation

Cited by 56 publications

References 0 publications

Back to the future: application of contemporary technology to long-standing questions about the clinical relevance of human leukocyte antigen-specific alloantibodies in renal transplantation

Back to the future: application of contemporary technology to long-standing questions about the clinical relevance of human leukocyte antigen-specific alloantibodies in renal transplantation

Clinical Relevance of Preformed HLA Donor-Specific Antibodies in Kidney Transplantation

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

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