No Association of Kidney Graft Loss With Human Leukocyte Antigen Antibodies Detected Exclusively by Sensitive Luminex Single-Antigen Testing: A Collaborative Transplant Study Report

• DOI: 10.1097/tp.0b013e3182100f77
• Publication Date: 2011-02-16T10:45:19Z
• Authors: Caner Süsal; Jörg Ovens; Khaled Mahmoud; Bernd Döhler; Sabine Scherer; Andrea Ruhenstroth; Thuong Hien Tran; Andreas Heinold; Gerhard Opelz
• Keywords: Donor-Specific Antibodies; Histocompatibility Testing; Isoantibodies

It is unclear whether kidney transplant recipients with preformed donor-specific human leukocyte antigen (HLA) antibodies (DSA) detectable only in the highly sensitive Luminex single-antigen (LSA) assay are at an increased risk of graft failure.We studied 3148 patients who received a deceased donor between 1996 and 2008 were enrolled prospective serum project Collaborative Transplant Study. There 118 loss during first 3 years after transplantation on whom recipient DNA was available for complete HLA typing. We compared incidence LSA-detected DSA these failure matched controls functioning grafts. All found negative less-sensitive complement-dependent lymphocytotoxicity enzyme-linked immunosorbent assays.When mean fluorescence intensity (MFI) greater than or equal to 1000 used as cutoff positivity, did not show higher against HLA-A, -B, -C, -DRB1/3/4/5, -DQA1, -DQB1, -DPA1, -DPB1 antigens without (for all loci P significant). The strong (MFI ≥2000 MFI ≥3000) detected by LSA low 0% 5%) identify unacceptable that relevant within transplantation.We conclude that, given currently practiced crossmatch procedures immunosuppressive regimens, exclusion organs carrying "unacceptable" based exclusively antibody testing justified.