PMID- 19307794
OWN - NLM
STAT- MEDLINE
DCOM- 20090522
LR  - 20090324
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 87
IP  - 4
DP  - 2009 Feb 27
TI  - Organ procurement and transplantation network/united network for organ sharing 
      histocompatibility committee collaborative study to evaluate prediction of 
      crossmatch results in highly sensitized patients.
PG  - 557-62
LID - 10.1097/TP.0b013e3181943c76 [doi]
AB  - BACKGROUND: The requirement for a prospective crossmatch limits some organ 
      allocation to local areas. The delay necessitated by the crossmatch restricts the 
      distance across which offers can be made without unduly increasing the ischemia 
      time. A collaborative study involving 14 transplant centers was undertaken by the 
      Organ Procurement and Transplantation Network/United Network for Organ Sharing 
      (OPTN/UNOS) Histocompatibility Committee to evaluate the accuracy with which the 
      detection of unacceptable human leukocyte antigen (HLA) antigens by most advanced 
      solid phase immunoassays can predict crossmatch results. In addition, using 
      actual patients' unacceptable HLA antigens, the number of compatible donors that 
      would have been available from the OPTN deceased kidney donors during 2002 to 
      2004 were investigated. METHODS: Panel reactive antibodies were performed by 
      conventional or solid phase assays, and crossmatches were performed by 
      cytotoxicity or flow cytometry. Analyses were stratified for T and B cell and by 
      method of identifying unacceptable HLA antigens and crossmatch techniques. 
      RESULTS: Combination of solid phase immunoassays and flow cytometry crossmatches 
      resulted in a higher prediction rates of positive T cell (86.1%-93.5%) and B-cell 
      crossmatches (91%-97.8%). Prediction of negative crossmatches based on different 
      combination of panel reactive antibodies and crossmatch techniques varied from 
      14.3% to 57.1%. Furthermore, numerous potential compatible donors were identified 
      for each patient, regardless of their ethnicity, in the OPTN database, when 
      predicted incompatible ones were excluded. CONCLUSIONS: The above results showed 
      that with the advent of solid phase immunoassays, HLA antibodies can now be 
      accurately detected resulting in prediction of crossmatch outcome. This should 
      facilitate organ allocation and prevents shipment of organs to distant 
      incompatible recipients.
FAU - Nikaein, Afzal
AU  - Nikaein A
AD  - OPTN/UNOS Histocompatibility Committee, Richmond, VA, USA. 
      Afzal.nikaein@hcahealthcare.com
FAU - Cherikh, Wida
AU  - Cherikh W
FAU - Nelson, Karen
AU  - Nelson K
FAU - Baker, Timothy
AU  - Baker T
FAU - Leffell, Sue
AU  - Leffell S
FAU - Bow, Laurine
AU  - Bow L
FAU - Crowe, Debbie
AU  - Crowe D
FAU - Connick, Ketra
AU  - Connick K
FAU - Head, Mary Ann
AU  - Head MA
FAU - Kamoun, Malek
AU  - Kamoun M
FAU - Kimball, Pam
AU  - Kimball P
FAU - Klohe, Ellen
AU  - Klohe E
FAU - Noreen, Harriet
AU  - Noreen H
FAU - Rebellato, Lorita
AU  - Rebellato L
FAU - Sell, Tom
AU  - Sell T
FAU - Sullivan, Karen
AU  - Sullivan K
FAU - Land, Geoffrey
AU  - Land G
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - B-Lymphocytes/*immunology
MH  - Enzyme-Linked Immunosorbent Assay
MH  - Flow Cytometry
MH  - HLA Antigens/immunology
MH  - Histocompatibility/immunology
MH  - Histocompatibility Testing/*methods
MH  - Humans
MH  - Isoantibodies/blood
MH  - Predictive Value of Tests
MH  - T-Lymphocytes/*immunology
MH  - Tissue Donors/*statistics & numerical data
MH  - Tissue and Organ Procurement/*methods/statistics & numerical data
EDAT- 2009/03/25 09:00
MHDA- 2009/05/23 09:00
CRDT- 2009/03/25 09:00
PHST- 2009/03/25 09:00 [entrez]
PHST- 2009/03/25 09:00 [pubmed]
PHST- 2009/05/23 09:00 [medline]
AID - 00007890-200902270-00015 [pii]
AID - 10.1097/TP.0b013e3181943c76 [doi]
PST - ppublish
SO  - Transplantation. 2009 Feb 27;87(4):557-62. doi: 10.1097/TP.0b013e3181943c76.