Impact of Low-level Donor-specific Antibody Determined With a Positive Luminex and Negative Flow Cytometric Crossmatch on Kidney Transplantation Outcomes
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초록
Since the introduction of the Luminex technique to detect donor-specific antibodies (DSAs) in kidney transplantation, efforts have been made to determine the risk of pre-operative low-level DSAs. The risk of low-level DSAs can be stratified by the mean fluorescence intensity (MFI), based on the highest level or sum [1]. However, the relative amount of antigen expressed on Luminex beads for each HLA locus varies from that expressed in vivo [2]. Therefore, caution is needed when applying the same MFI criteria to each HLA locus. Accordingly, the flow cytometric crossmatch test, which detects the actual binding of a DSA to donor lymphocytes, remains an important pre-transplantation test despite recognized limitations such as inter-laboratory and person-to-person variations or false positives due to non-HLA antibodies [3]. Therefore, it is meaningful to analyze the clinical impact of pre-operative low-level DSAs determined by a positive Luminex result but negative flow cytometric crossmatch (PLNF) on kidney transplantation outcomes.
Abstract
Since the introduction of the Luminex technique to detect donor-specific antibodies (DSAs) in kidney transplantation, efforts have been made to determine the risk of pre-operative low-level DSAs. The risk of low-level DSAs can be stratified by the mean fluorescence intensity (MFI), based on the highest level or sum [1]. However, the relative amount of antigen expressed on Luminex beads for each HLA locus varies from that expressed in vivo [2]. Therefore, caution is needed when applying the same MFI criteria to each HLA locus. Accordingly, the flow cytometric crossmatch test, which detects the actual binding of a DSA to donor lymphocytes, remains an important pre-transplantation test despite recognized limitations such as inter-laboratory and person-to-person variations or false positives due to non-HLA antibodies [3]. Therefore, it is meaningful to analyze the clinical impact of pre-operative low-level DSAs determined by a positive Luminex result but negative flow cytometric crossmatch (PLNF) on kidney transplantation outcomes.
참고문헌 (14)
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