Toward a sensible single antigen bead cut-off based on kidney graft survival

Autor: Bram W. Wisse, Johan W. de Fijter, Shaikh A. Nurmohamed, Karlijn A M I van der Pant, N M Lardy, Ineke J. M. ten Berge, M. Gelens, Sebastiaan Heidt, Michiel L. Bots, Andries J. Hoitsma, Adriaan C.A.D. Drop, Arnold van der Meer, Luuk B. Hilbrands, Frans J. van Ittersum, Frederike J. Bemelman, Dave L. Roelen, Paul J M van der Boog, Jan-Stephan F. Sanders, Arjan D. van Zuilen, Loes Plaisier, Wendy Swelsen, Michiel G. H. Betjes, Cornelis E. Hack, Franka E. van Reekum, Elly M. van Duijnhoven, Laura Bungener, Caroline Roozendaal, Henny G. Otten, Marije C. Baas, Bouke G. Hepkema, Neelke C. van der Weerd, Christina E.M. Voorter, Frans H.J. Claas, Eric Spierings, Lotte Wieten, Wil A. Allebes, Irma Joosten, Marianne C. Verhaar, Marcel G.J. Tilanus, Annechien J. A. Lambeck, Elena G. Kamburova, Maarten H. L. Christiaans, Marc A. Seelen
Přispěvatelé: Oral and Maxillofacial Surgery, Erasmus MC other, Internal Medicine, Groningen Institute for Organ Transplantation (GIOT), Groningen Kidney Center (GKC), Nephrology, ACS - Atherosclerosis & ischemic syndromes, ACS - Diabetes & metabolism, AII - Inflammatory diseases, Interne Geneeskunde, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: DA TI Staf (9), MUMC+: DA TI Laboratorium (9), MUMC+: MA Nefrologie (9), APH - Aging & Later Life
Jazyk: angličtina
Rok vydání: 2019
Předmět:
medicine.medical_specialty
Urology
Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0]
Human leukocyte antigen
030230 surgery
Fluorescence
03 medical and health sciences
0302 clinical medicine
HLA Antigens
Isoantibodies
STRENGTH
Medicine
Cutoff
Humans
Single antigen bead
Kidney transplantation
Kidney
Transplantation
business.industry
Graft Survival
Original Clinical Science—General
medicine.disease
Kidney Transplantation
Tissue Donors
body regions
HLA
medicine.anatomical_structure
Risk stratification
ANTIBODIES
ComputingMethodologies_DOCUMENTANDTEXTPROCESSING
030211 gastroenterology & hepatology
Graft survival
Renal disorders Radboud Institute for Health Sciences [Radboudumc 11]
business
Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5]
Zdroj: Transplantation, 103(4), 789. Lippincott Williams and Wilkins
Transplantation
Transplantation, 103, 789-797
Transplantation, 103(4), 789-797. Lippincott Williams & Wilkins
Transplantation, 103, 4, pp. 789-797
Transplantation, 103(4), 789-797. LIPPINCOTT WILLIAMS & WILKINS
Transplantation, 103(4), 789-797
Transplantation, 103(4), 789-797. Lippincott Williams and Wilkins
Wisse, B W, Kamburova, E G, Joosten, I, Allebes, W A, van der Meer, A, Hilbrands, L B, Baas, M C, Spierings, E, Hack, C E, van Reekum, F E, van Zuilen, A D, Verhaar, M C, Bots, M L, Drop, A C A D, Plaisier, L, Seelen, M A J, Stephan Sanders, J, Hepkema, B G, Lambeck, A J A, Bungener, L B, Roozendaal, C, Tilanus, M G J, Voorter, C E, Wieten, L, van Duijnhoven, E M, Gelens, M A C J, Christiaans, M H L, van Ittersum, F J, Nurmohamed, S A, Lardy, N M, Swelsen, W, van der Pant, K A M I, van der Weerd, N C, ten Berge, I J M, Bemelman, F J, Hoitsma, A J, van der Boog, P J M, de Fijter, J W, Betjes, M G H, Heidt, S, Roelen, D L, Claas, F H & Otten, H G 2019, ' Toward a Sensible Single-antigen Bead Cutoff Based on Kidney Graft Survival ', Transplantation, vol. 103, no. 4, pp. 789-797 . https://doi.org/10.1097/TP.0000000000002357
ISSN: 0041-1337
DOI: 10.1097/TP.0000000000002357
Popis: Supplemental Digital Content is available in the text.
Background. There is no consensus in the literature on the interpretation of single-antigen bead positive for a specific HLA antibody. Methods. To inform the debate, we studied the relationship between various single-antigen bead positivity algorithms and the impact of resulting donor-specific HLA antibody (DSA) positivity on long-term kidney graft survival in 3237 deceased-donor transplants. Results. First, we showed that the interassay variability can be greatly reduced when working with signal-to-background ratios instead of absolute median fluorescence intensities (MFIs). Next, we determined pretransplant DSA using various MFI cutoffs, signal-to-background ratios, and combinations thereof. The impact of the various cutoffs was studied by comparing the graft survival between the DSA-positive and DSA-negative groups. We did not observe a strong impact of various cutoff levels on 10-year graft survival. A stronger relationship between the cutoff level and 1-year graft survival for DSA-positive transplants was found when using signal-to-background ratios, most pronounced for the bead of the same HLA locus with lowest MFI taken as background. Conclusions. With respect to pretransplant risk stratification, we propose a signal-to-background ratio-6 (using the bead of the same HLA-locus with lowest MFI as background) cutoff of 15 combined with an MFI cutoff of 500, resulting in 8% and 21% lower 1- and 10-year graft survivals, respectively, for 8% DSA-positive transplants.
Databáze: OpenAIRE
Externí odkaz: