PMID- 22710388
OWN - NLM
STAT- MEDLINE
DCOM- 20130423
LR  - 20181201
IS  - 1531-7013 (Electronic)
IS  - 1087-2418 (Linking)
VI  - 17
IP  - 4
DP  - 2012 Aug
TI  - New approaches for detecting complement-fixing antibodies.
PG  - 409-15
LID - 10.1097/MOT.0b013e328355fb9b [doi]
AB  - PURPOSE OF REVIEW: Complement-fixing human leukocyte antigen (HLA) antibodies are 
      a contraindication to solid organ transplant. Newer solid phase assays for HLA 
      antibody definition have created treatment quandaries because many more 
      antibodies are detected by these methods. It is unclear which of the antibodies 
      identified are clinically relevant as all IgG-binding antibodies are detected 
      whether they can fix complement or not. RECENT FINDINGS: Two methods have been 
      developed to assess complement-fixing capability in the solid phase assays: C4d 
      and C1q. These assays, especially the sensitive C1q method, have been reported to 
      more closely correlate with renal and cardiac graft dysfunction, rejection, and 
      graft failure than antibodies detected only by the traditional IgG method. 
      Additionally, the C1q method can be used to predict and monitor desensitization 
      status pre and posttransplant in patients being treated with intravenous 
      immunoglobulin. SUMMARY: The availability of these complement-fixing assays 
      provides new tools for making treatment decisions by discriminating antibodies 
      with known clinical relevance and to assess the clinical relevance of binding 
      antibodies that cannot fix complement. The assays also provide a means of 
      assessing when to transplant a patient undergoing desensitization or when to 
      discontinue augmented immunosuppression for resolving antibody-mediated 
      rejection.
FAU - Tyan, Dolly B
AU  - Tyan DB
AD  - Department of Pathology, Stanford University School of Medicine, California 
      94304, USA. dtyan@stanfordedu
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Opin Organ Transplant
JT  - Current opinion in organ transplantation
JID - 9717388
RN  - 0 (Antibodies)
RN  - 0 (HLA Antigens)
RN  - 0 (Peptide Fragments)
RN  - 80295-33-6 (Complement C1q)
RN  - 80295-50-7 (Complement C4b)
RN  - 80295-52-9 (complement C4d)
RN  - 9007-36-7 (Complement System Proteins)
SB  - IM
MH  - Antibodies/blood/*immunology
MH  - Complement C1q/analysis/immunology
MH  - Complement C4b/immunology
MH  - Complement System Proteins/*analysis/immunology
MH  - Graft Rejection/*diagnosis/immunology
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - Peptide Fragments/blood/immunology
EDAT- 2012/06/20 06:00
MHDA- 2013/04/24 06:00
CRDT- 2012/06/20 06:00
PHST- 2012/06/20 06:00 [entrez]
PHST- 2012/06/20 06:00 [pubmed]
PHST- 2013/04/24 06:00 [medline]
AID - 10.1097/MOT.0b013e328355fb9b [doi]
PST - ppublish
SO  - Curr Opin Organ Transplant. 2012 Aug;17(4):409-15. doi: 
      10.1097/MOT.0b013e328355fb9b.