PMID- 21325993
OWN - NLM
STAT- MEDLINE
DCOM- 20110603
LR  - 20220311
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 91
IP  - 8
DP  - 2011 Apr 27
TI  - No association of kidney graft loss with human leukocyte antigen antibodies 
      detected exclusively by sensitive Luminex single-antigen testing: a Collaborative 
      Transplant Study report.
PG  - 883-7
LID - 10.1097/TP.0b013e3182100f77 [doi]
AB  - BACKGROUND: 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. METHODS: We studied 3148 patients who received a deceased donor 
      kidney graft between 1996 and 2008 and were enrolled in the prospective serum 
      project of the Collaborative Transplant Study. There were 118 patients with graft 
      loss during the first 3 years after transplantation on whom recipient and donor 
      DNA was available for complete HLA typing. We compared the incidence of 
      LSA-detected DSA in these patients with graft failure and matched controls with 
      functioning grafts. All patients were found negative in the less-sensitive 
      complement-dependent lymphocytotoxicity and enzyme-linked immunosorbent assays. 
      RESULTS: When mean fluorescence intensity (MFI) of greater than or equal to 1000 
      was used as a cutoff for Luminex positivity, 118 patients with graft loss did not 
      show a higher incidence of DSA against HLA-A, -B, -C, -DRB1/3/4/5, -DQA1, -DQB1, 
      -DPA1, or -DPB1 antigens than 118 matched controls without graft loss (for all 
      loci P not significant). The incidence of strong DSA (MFI >/=2000 or MFI >/=3000) 
      detected only by LSA was low (for all loci between 0% and 5%) and did not 
      identify unacceptable antigens that were relevant for graft loss within the first 
      3 years after transplantation. CONCLUSION: We conclude that, given currently 
      practiced crossmatch procedures and immunosuppressive regimens, exclusion of 
      donor organs carrying "unacceptable" HLA based exclusively on sensitive LSA 
      antibody testing is not justified.
CI  - (c) 2011 by Lippincott Williams & Wilkins
FAU - Susal, Caner
AU  - Susal C
AD  - Department of Transplantation Immunology, Institute of Immunology, University of 
      Heidelberg, Heidelberg, Germany. caner.suesal@med.uni-heidelberg.de
FAU - Ovens, Jorg
AU  - Ovens J
FAU - Mahmoud, Khaled
AU  - Mahmoud K
FAU - Dohler, Bernd
AU  - Dohler B
FAU - Scherer, Sabine
AU  - Scherer S
FAU - Ruhenstroth, Andrea
AU  - Ruhenstroth A
FAU - Tran, Thuong Hien
AU  - Tran TH
FAU - Heinold, Andreas
AU  - Heinold A
FAU - Opelz, Gerhard
AU  - Opelz G
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Antibodies)
RN  - 0 (HLA Antigens)
RN  - 0 (Immunosuppressive Agents)
SB  - IM
CIN - Transplantation. 2011 Aug 27;92(4):e15; author reply e15-6. PMID: 21814123
MH  - Antibodies/*blood
MH  - Case-Control Studies
MH  - *Enzyme-Linked Immunosorbent Assay
MH  - Female
MH  - Germany
MH  - Graft Rejection/blood/*immunology/prevention & control
MH  - *Graft Survival/drug effects
MH  - HLA Antigens/*immunology
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Kidney Transplantation/*immunology
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
MH  - Treatment Outcome
EDAT- 2011/02/18 06:00
MHDA- 2011/06/04 06:00
CRDT- 2011/02/18 06:00
PHST- 2011/02/18 06:00 [entrez]
PHST- 2011/02/18 06:00 [pubmed]
PHST- 2011/06/04 06:00 [medline]
AID - 10.1097/TP.0b013e3182100f77 [doi]
PST - ppublish
SO  - Transplantation. 2011 Apr 27;91(8):883-7. doi: 10.1097/TP.0b013e3182100f77.