Abrogating biologics interference in flow cytometric crossmatching.

Autor: Franz BJ; Histocompatibility Laboratory, McLendon Clinical Laboratories, UNC Hospitals, Chapel Hill, NC, USA., Petraroia R; Histocompatibility Laboratory, McLendon Clinical Laboratories, UNC Hospitals, Chapel Hill, NC, USA., Faust CD; Histocompatibility Laboratory, McLendon Clinical Laboratories, UNC Hospitals, Chapel Hill, NC, USA., Crawford T; Histocompatibility Laboratory, McLendon Clinical Laboratories, UNC Hospitals, Chapel Hill, NC, USA., Smalls S; Histocompatibility Laboratory, McLendon Clinical Laboratories, UNC Hospitals, Chapel Hill, NC, USA., Vongsavanh C; Histocompatibility Laboratory, McLendon Clinical Laboratories, UNC Hospitals, Chapel Hill, NC, USA., Gibson K; Division Pediatric Nephrology, Department of Pediatrics, UNC School of Medicine, Chapel Hill, NC, USA., Schmitz JL; Histocompatibility Laboratory, McLendon Clinical Laboratories, UNC Hospitals, Chapel Hill, NC, USA; Department of Pathology & Laboratory Medicine, UNC School of Medicine, Chapel Hill, NC, USA. Electronic address: John.Schmitz@unchealth.unc.edu.
Jazyk: angličtina
Zdroj: Human immunology [Hum Immunol] 2021 Aug; Vol. 82 (8), pp. 574-580. Date of Electronic Publication: 2021 Apr 30.
DOI: 10.1016/j.humimm.2021.01.016
Abstrakt: The flow cytometric crossmatch is currently the gold standard for evaluating donor and recipient histocompatibility. The assay however does have limitations and is sensitive to false positive reactions resulting from the presence of non-HLA antibodies or therapy related immune biologics. Such false positive reactions can lead to the inappropriate decline of an acceptable donor organ or unnecessary therapeutic intervention. Here we describe the successful validation of anti-idiotype blocking antibodies in prevention of false positive flow crossmatch results caused by biologic therapy. Blocking antibodies specific for the Fab portion of Rituximab and/or Alemtuzumab were incubated with biologic containing patient serum prior to use in flow cytometric crossmatching. Biologic blocking successfully negated false positive crossmatch results with Rituximab (B cell ave. % change = -97%) or Alemtuzumab (T cell ave. % change = -99%, B cell ave. % change = -95%) infused sera respectively. Simultaneous blocking of these biologics was also successful. A complex case is presented to demonstrate the application of this procedure.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2021 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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