PMID- 16699463
OWN - NLM
STAT- MEDLINE
DCOM- 20060626
LR  - 20060515
IS  - 0041-1337 (Print)
IS  - 0041-1337 (Linking)
VI  - 81
IP  - 9
DP  - 2006 May 15
TI  - Utility of HLAMatchmaker and single-antigen HLA-antibody detection beads for 
      identification of acceptable mismatches in highly sensitized patients awaiting 
      kidney transplantation.
PG  - 1331-6
AB  - BACKGROUND: In highly sensitized patients (HSP) awaiting renal transplantation, 
      accurate delineation of acceptable human leukocyte antigen (HLA) mismatches (AMM) 
      aids identification of suitable crossmatch negative donors. Comparison of 
      differences in polymorphic triplet amino acid sequences in antibody accessible 
      regions of HLA may predict immunogenicity. We have examined the ability of the 
      HLAMatchmaker computer algorithm to predict AMM determined by antibody screening 
      using the full repertoire of single-antigen HLA-A and -B specificities. METHODS: 
      The HLA types of 24 HSP awaiting kidney transplantation were analyzed using 
      HLAMatchmaker to determine the number of triplet amino acid (TAA) mismatches for 
      each of 64 mismatched HLA-A and -B specificities. Patient sera with the highest 
      immunoglobulin (Ig)G HLA-specific antibody reactivity were tested against the 64 
      individual HLA-A and -B specificities using single-antigen HLA antibody detection 
      beads. Logistic regression analysis was performed to determine the association 
      between AMM and the number of TAA mismatches. RESULTS: There was a strong 
      positive association between the number of TAA mismatches and the presence of 
      HLA-specific antibody. HLA specificities with zero TAA mismatches were antibody 
      positive in only 4 of 47 (9%) cases. A single TAA mismatches was sufficient to 
      invoke an antibody response in 40 (41%) of 98 cases, increasing to 97 (87%) of 
      112 cases with 9 or more TAA mismatches. However, there was considerable 
      heterogeneity between individual patients, and only 16 (67%) of the 24 HSP 
      studied fitted the logistic regression model for TAA mismatches and HLA-specific 
      antibody. CONCLUSIONS: Identification of TAA mismatches using HLAMatchmaker is a 
      helpful tool for predicting potential donors with an acceptable HLA mismatch in 
      HSP.
FAU - Goodman, Reyna S
AU  - Goodman RS
AD  - Tissue Typing Laboratory, Cambridge University Hospitals NHS Foundation Trust, 
      Cambridge, United Kingdom.
FAU - Taylor, Craig J
AU  - Taylor CJ
FAU - O'Rourke, Cheryl M
AU  - O'Rourke CM
FAU - Lynch, Andrew
AU  - Lynch A
FAU - Bradley, J Andrew
AU  - Bradley JA
FAU - Key, Tim
AU  - Key T
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Antigen-Antibody Complex)
RN  - 0 (HLA Antigens)
RN  - 0 (HLA-A Antigens)
RN  - 0 (HLA-B Antigens)
RN  - 0 (Histocompatibility Antigens Class I)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Adult
MH  - Amino Acid Sequence
MH  - Antigen-Antibody Complex
MH  - Blood Transfusion
MH  - Female
MH  - HLA Antigens/*immunology
MH  - HLA-A Antigens/immunology
MH  - HLA-B Antigens/immunology
MH  - Histocompatibility Antigens Class I/*immunology
MH  - Histocompatibility Testing/*methods
MH  - Humans
MH  - Immunization/methods
MH  - Isoantibodies/*blood
MH  - Kidney Transplantation/*immunology
MH  - Male
MH  - Middle Aged
MH  - Regression Analysis
MH  - Reoperation/statistics & numerical data
MH  - *Waiting Lists
EDAT- 2006/05/16 09:00
MHDA- 2006/06/27 09:00
CRDT- 2006/05/16 09:00
PHST- 2006/05/16 09:00 [pubmed]
PHST- 2006/06/27 09:00 [medline]
PHST- 2006/05/16 09:00 [entrez]
AID - 00007890-200605150-00018 [pii]
AID - 10.1097/01.tp.0000205202.56915.f5 [doi]
PST - ppublish
SO  - Transplantation. 2006 May 15;81(9):1331-6. doi: 
      10.1097/01.tp.0000205202.56915.f5.