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Nephrol Dial Transplant. 2012 Mar;27(3):1231-8. doi: 10.1093/ndt/gfr429. Epub 2011 Aug 2.

Clinical relevance of HLA donor-specific antibodies detected by single antigen assay in kidney transplantation.

Author information

1
Servicio de Inmunología, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina (IBIS), Seville, Spain.

Abstract

BACKGROUND:

Clinical relevance of donor-specific antibodies (DSAs) detected by a single antigen Luminex virtual crossmatch in pre-transplant serum samples from patients with a negative cytotoxicity-dependent complement crossmatch is controversial. The aim of this study was to analyse the influence of a pre-transplant positive virtual crossmatch in the outcome of kidney transplantation.

METHODS:

A total of 892 patients who received a graft from deceased donors after a negative cytotoxicity crossmatch were included. Presence of anti-human leucocyte antigen (HLA) antibodies was investigated using a Luminex screening assay and anti-HLA specificities were assigned performing a Luminex single antigen assay.

RESULTS:

Graft survival was significantly worse among patients with anti-HLA DSA compared to both patients with anti-HLA with no DSA (P = 0.001) and patients without HLA antibodies (P < 0.001) using a log-rank test. No graft survival differences between anti-HLA with no DSA and no HLA antibodies patient groups were observed (P = 0.595). Influence of both anti-Class I and anti-Class II DSA was detected (P < 0.0001 in both cases). When the fluorescence values were stratified in four groups, no significant differences in graft survival were observed among the groups with fluorescence levels >1500 (global P > 0.05).

CONCLUSIONS:

The presence of preformed HLA DSA in transplanted patients with a negative cytotoxicity crossmatch is associated with a lower allograft survival. The detection of anti-HLA with no DSA has no influence in the graft outcome. Finally, there were no demonstrable effects of mean fluorescence intensity (MFI) values >1500 on graft survival.

PMID:
21810767
DOI:
10.1093/ndt/gfr429
[Indexed for MEDLINE]

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