| Autor: |
Pandey P; Department of Transfusion Medicine, Histocompatibility & Molecular Biology, Jaypee Hospital, Noida (U.P), India., Pande A; Department of Transfusion Medicine, Histocompatibility & Molecular Biology, Jaypee Hospital, Noida (U.P), India., Mishra S; Department of Transfusion Medicine, Histocompatibility & Molecular Biology, Jaypee Hospital, Noida (U.P), India., Setya D; Department of Transfusion Medicine, Jaypee Hospital, Noida (U.P), India., Devra AK; Department of Urology and Kidney Transplant, Jaypee Hospital, Noida (U.P), India., Sinha VK; Department of Urology and Kidney Transplant, Jaypee Hospital, Noida (U.P), India., Bhatt AP; Department of Urology and Kidney Transplant, Jaypee Hospital, Noida (U.P), India. |
| Abstrakt: |
<b>Introduction:</b> Cell-based complement-dependent cytotoxicity crossmatch (CDC-XM) and solid phase assays were introduced for assessing HLA antibodies. However, the complexity of data from cell-based and solid phase assays have led to potential confusion about how to use the results for clinical decision making. </br></br> <b> Aim:</b> Aim of this study was to compare results of cell-based assay and solid phase assay, to evaluate the usefulness of L-XM for pretransplant detection of HLA class I and II donor-specific IgG antibodies, correlate the mean fluorescence intensity (MFI) values of class I and class II L-XM assay and with CDC-XM and L-PRA (panel reactive antibodies) results. </br></br> <b> Methods:</b> In this retrospective study, 380 prospective renal transplant recipients were tested for the presence of HLA antibodies by CDC-XM, IgG-L-XM, IgG-L-PRA & L-SAB screening with their corresponding donor. </br></br> <b>Results:</b> Fifty-one recipients (13.42%) had a positive CDC-XM. L-XM was positive in 125 recipients (32.89%); class I-L-XM was positive in 46 (36.80%) cases, and class II-L-XM was positive in 58 (46.4%) cases and 21 (16.8%) samples were positive for class I and class II. High background was present in 22 (5.87%) samples, the results of which were confirmed by retesting or by correlation with L-PRA and L-SAB assays. </br></br> <b>Conclusion:</b> The introduction of more sensitive approaches for the detection of anti-HLA-IgG-antibodies, such as L-XM and L-PRA assay, has allowed the identification of anti-HLA-antibodies in recipient serum which is not usually identified by CDC-XM alone. However, L-XM has some limitations; they can be overcome if we combine this assay with L-PRA. |
