Toward a Sensible Single-antigen Bead Cutoff Based on Kidney Graft Survival

Wisse, Bram W.; Kamburova, Elena G.; Joosten, Irma; Allebes, Wil A.; Meer, Arnold van der; Hilbrands, Luuk B.; Baas, Marije C.; Spierings, Eric; Hack, C. E.; Reekum, Franka E. van; Zuilen, Arjan D. van; Verhaar, Marianne C.; Bots, Michiel L.; Drop, Adriaan C.A.D.; Plaisier, Loes; Seelen, Marc A.; Sanders, Jan-Stephan; Hepkema, Bouke; Lambeck, Annechien J. A.; Bungener, Laura; Roozendaal, Caroline; Tilanus, Marcel G.J.; Voorter, Christina E.M.; Wieten, Lotte; Duijnhoven, Elly M. van; Gelens, M.; Christiaans, Maarten H. L.; Ittersum, Frans J. van; Nurmohamed, Shaikh A.; Lardy, Neubury M.; Swelsen, Wendy; Pant, Karlijn A M I van der; Weerd, Neelke C. van der; Berge, Ineke J. M. ten; Bemelman, Fréderike J.; Hoitsma, Andries J.; Boog, Paul J.M. van der; Fijter, Johan W. de; Betjes, M.; Heidt, Sebastiaan; Roelen, Dave L.; Claas, Frans H.J.; Otten, Henny G.

doi:10.1097/tp.0000000000002357

Cited by 32 publications

(30 citation statements)

References 8 publications

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“…The MFI cutoff for a clinically relevant positive SAB results is widely debated . We believe that it should be defined together with the transplant center in the context of an overall risk stratification concept.…”

Section: Clinical Impact Of Pretransplant Dsa Defined By Sabmentioning

confidence: 99%

Caveats of HLA antibody detection by solid‐phase assays

2019

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All authors contributed equally to the review SUMMARY Solid-phase assays for human leukocyte antigens (HLA) antibody detection have clearly revolutionized the field of HLA diagnostics and transplantation. The key advantages are a high sensitivity and specificity for detection of HLA antibodies compared with cell-based assays, as well as the potential for standardization. Solid-phase assays enabled the broad introduction of tools such as "virtual crossmatching" and "calculated panel reactive antibodies," which are essential components in many organ allocation systems, kidney-paired donation programs, and center-specific immunological risk stratification procedures. The most advanced solid-phase assays are the socalled single antigen beads (SAB). They are available now for more than 15 years, and the transplant community embraced their significant advantages. However, SAB analysis and interpretation is complex and many pitfalls have to be considered. In this review, we will discuss problems, limitations, and challenges using SAB. Furthermore, we express our wishes for improvements of SAB as well as their future use for immunological assessment and research purposes.

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Section: Clinical Impact Of Pretransplant Dsa Defined By Sabmentioning

confidence: 99%

Caveats of HLA antibody detection by solid‐phase assays

2019

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“…To this end, we chose to define a clinically relevant cut-off as it was previously described for HLA antibodies using a combination of STBR combined with a minimal MFI level. 26 Using individual cut-offs for each non-HLA antibody, optimally discriminating patients with long-term functioning grafts vs graft loss, we did not find associations between the presence of any of the abovementioned previously studied non-HLA antibodies and graft loss, function, or rejection. We did not analyze the autoantibody MFI levels as continuous variables, because in the field of anti-HLA antibodies it is well accepted that MFI is not an indication of antibody titer and is influenced by sev- In our study, non-HLA proteins were coated directly or indirectly (via HaloTag) to the microspheres.…”

Section: Discussionmentioning

confidence: 50%

“…To this end, we chose to define a clinically relevant cut-off as it was previously described for HLA antibodies using a combination of STBR combined with a minimal MFI level 26. This definition does not necessarily provide the most clinically relevant cut-off value with regard to prognosis.…”

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confidence: 99%

Antibodies against ARHGDIB are associated with long-term kidney graft loss

Kamburova

Gruijters

Kardol‐Hoefnagel

et al. 2019

American Journal of Transplantation

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Shaikh A. Nurmohamed 11 | Neubury M. Lardy 12 | Wendy Swelsen 12 | Karlijn A. M. I. van der Pant 2 | Neelke C. van der Weerd 2 | Ineke J. M. ten Berge 2 |This is an open access article under the terms of the Creat ive Commo ns Attri bution-NonCo mmercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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“…To define the signal which is best related with graft loss, we analyzed MFI signals from all autoantibodies simultaneously for absolute MFI and signal‐to‐background ratios. This analysis was performed similar to a recent study yielding a sensible single antigen bead cut‐off for HLA antibodies with optimal association with graft loss . For each of these ratios, cutoffs, and their combinations, the difference in graft survival at year 1, 5, and 10 was calculated which maximally discriminates in graft loss between positive and negative patients.…”

Section: Non‐hla Antibodies In Kidney Transplantationmentioning

confidence: 99%

“…The PROCARE study allowed analysis of outcome of transplantations, with donor acceptance unbiased by results and knowledge that were post‐hoc obtained with techniques used in PROCARE study. Recommendations reflecting the impact of parameters from that study are currently well appreciated …”

Section: Introductionmentioning

confidence: 99%

Results and reflections from the PROfiling Consortium on Antibody Repertoire and Effector functions in kidney transplantation: A mini‐review

Kamburova

Hoitsma

Claas

et al. 2019

HLA

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Kidney transplantation is the best treatment option for patients with end‐stage renal disease (ESRD). The waiting time for a deceased donor kidney in the Netherlands is approximately 3 years. Mortality among patients on the waiting list is high. The aim of the PROCARE consortium (PROfiling Consortium on Antibody Repertoire and Effector functions) was to decrease the waiting time by providing a matching algorithm yielding a prolonged graft survival and less HLA‐immunization compared with the currently used Eurotransplant Kidney allocation system. In this study, 6097 kidney transplants carried out between January 1995 and December 2005 were re‐examined with modern laboratory techniques and insights that were not available during that time period. In this way, we could identify potential new parameters that can be used to improve the matching algorithm and prolong graft survival. All eight University Medical Centers in the Netherlands participated in this multicenter study. To improve the matching algorithm, we used as central hypothesis that the combined presence of class‐I and ‐II single‐antigen bead (SAB)‐defined donor‐specific HLA antibodies (DSA) prior to transplantation, non‐HLA antibodies, the number of B‐ and/or T‐cell epitopes recognized on donor HLA, and specific polymorphisms in effector mechanisms of IgG were associated with an increased risk for graft failure. The purpose of this article is to relate the results obtained from the PROCARE consortium study to other studies published in recent years. The clinical relevance of SAB‐defined DSA, complement‐fixing DSA, non‐HLA antibodies, and the effector functions of (non)‐HLA‐antibodies will be discussed.

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Toward a Sensible Single-antigen Bead Cutoff Based on Kidney Graft Survival

Cited by 32 publications

References 8 publications

Caveats of HLA antibody detection by solid‐phase assays

Caveats of HLA antibody detection by solid‐phase assays

Antibodies against ARHGDIB are associated with long-term kidney graft loss

Results and reflections from the PROfiling Consortium on Antibody Repertoire and Effector functions in kidney transplantation: A mini‐review

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