PMID- 24170304
OWN - NLM
STAT- MEDLINE
DCOM- 20141114
LR  - 20211021
IS  - 1179-2000 (Electronic)
IS  - 1177-1062 (Linking)
VI  - 18
IP  - 2
DP  - 2014 Apr
TI  - Sensitive solid-phase detection of donor-specific antibodies as an aid highly 
      relevant to improving allograft outcomes.
PG  - 185-201
LID - 10.1007/s40291-013-0063-2 [doi]
AB  - Transplant recipients who have had sensitizing events such as pregnancies, blood 
      transfusions and previous transplants often develop antibodies directed against 
      human leukocyte antigen (HLA)-molecules of the donor tissue. These pre-formed 
      donor-specific antibodies (DSA) represent a high risk of organ failure as a 
      consequence of antibody-mediated hyper-acute or acute allograft rejection. As a 
      first assay to detect DSA, the complement-dependent lymphocytotoxicity assay 
      (CDC) was established more than 40 years ago. However, this assay is 
      characterized by several drawbacks such as a low sensitivity and a high 
      susceptibility to various artificial factors generally not leading to valid and 
      reliable outcomes under several circumstances that are reviewed in this article. 
      Furthermore, only those antibodies that exert complement-fixing activity are 
      detected. As a consequence, novel procedures that act independently of the 
      complement system and that do not represent functional assays were generated in 
      the format of solid phase assays (SPAs) (bead- or ELISA-based). In this article, 
      we review the pros and cons of these sensitive SPA in comparison with the 
      detection of DSA through the use of the traditional methods such as CDC and flow 
      cytometric analyses. Potential drawbacks of the alternative methodological 
      approaches comprising high background reactivity, susceptibility to environmental 
      factors and the possible influence of subjective operators' errors concerning the 
      interpretation of the results are summarized and critically discussed for each 
      method. We provide a forecast on the future role of SPAs reliably excluding 
      highly deleterious DSA, thus leading to an improved graft survival.
FAU - Schlaf, Gerald
AU  - Schlaf G
AD  - Tissue Typing Laboratory, University Hospital Halle/Saale, Martin-Luther 
      University of Halle-Wittenberg, Magdeburger Strasse 16, 06112, Halle (Saale), 
      Germany, gerald.schlaf@uk-halle.de.
FAU - Pollok-Kopp, Beatrix
AU  - Pollok-Kopp B
FAU - Altermann, Wolfgang W
AU  - Altermann WW
LA  - eng
PT  - Journal Article
PT  - Review
PL  - New Zealand
TA  - Mol Diagn Ther
JT  - Molecular diagnosis & therapy
JID - 101264260
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Allografts/*immunology
MH  - Antibody Specificity
MH  - Enzyme-Linked Immunosorbent Assay
MH  - Flow Cytometry
MH  - Graft Rejection/*immunology
MH  - Graft Survival/immunology
MH  - HLA Antigens/*analysis
MH  - Humans
MH  - Phenotype
EDAT- 2013/10/31 06:00
MHDA- 2014/11/15 06:00
CRDT- 2013/10/31 06:00
PHST- 2013/10/31 06:00 [entrez]
PHST- 2013/10/31 06:00 [pubmed]
PHST- 2014/11/15 06:00 [medline]
AID - 10.1007/s40291-013-0063-2 [doi]
PST - ppublish
SO  - Mol Diagn Ther. 2014 Apr;18(2):185-201. doi: 10.1007/s40291-013-0063-2.