PMID- 27200498
OWN - NLM
STAT- MEDLINE
DCOM- 20171116
LR  - 20181202
IS  - 1531-7013 (Electronic)
IS  - 1087-2418 (Print)
IS  - 1087-2418 (Linking)
VI  - 21
IP  - 4
DP  - 2016 Aug
TI  - Clinically relevant interpretation of solid phase assays for HLA antibody.
PG  - 453-8
LID - 10.1097/MOT.0000000000000326 [doi]
AB  - PURPOSE OF REVIEW: Accurate and timely detection and characterization of human 
      leukocyte antigen (HLA) antibodies are critical for pre-transplant and 
      post-transplant immunological risk assessment. Solid phase immunoassays have 
      provided increased sensitivity and specificity, but test interpretation is not 
      always straightforward. This review will discuss the result interpretation 
      considering technical limitations; assessment of relative antibody strength; and 
      the integration of data for risk stratification from complementary testing and 
      the patient's immunological history. RECENT FINDINGS: Laboratory and clinical 
      studies have provided insight into causes of test failures - false positive 
      reactions because of antibodies to denatured HLA antigens and false negative 
      reactions resulting from test interference and/or loss of native epitopes. Test 
      modifications permit detection of complement-binding antibodies and determination 
      of the IgG subclasses. The high degree of specificity of single antigen solid 
      phase immunoassays has revealed the complexity and clinical relevance of 
      antibodies to HLA-C, HLA-DQ, and HLA-DP antigens. Determination of antibody 
      specificity for HLA epitopes enables identification of incompatible antigens not 
      included in test kits. SUMMARY: Detection and characterization of HLA antibodies 
      with solid phase immunoassays has led to increased understanding of the role of 
      those antibodies in graft rejection, improved treatment of antibody-mediated 
      rejection, and increased opportunities for transplantation. However, realization 
      of these benefits requires careful and accurate interpretation of test results.
FAU - Bettinotti, Maria P
AU  - Bettinotti MP
AD  - Division of Immunogenetics and Transplantation Immunology, Department of 
      Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, 
      USA.
FAU - Zachary, Andrea A
AU  - Zachary AA
FAU - Leffell, Mary S
AU  - Leffell MS
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 (HLA Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - HLA Antigens/*immunology
MH  - Histocompatibility Testing/*methods
MH  - Humans
MH  - Isoantibodies/*immunology
PMC - PMC4936436
EDAT- 2016/05/21 06:00
MHDA- 2017/11/29 06:00
PMCR- 2016/07/07
CRDT- 2016/05/21 06:00
PHST- 2016/05/21 06:00 [entrez]
PHST- 2016/05/21 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
PHST- 2016/07/07 00:00 [pmc-release]
AID - 10.1097/MOT.0000000000000326 [doi]
PST - ppublish
SO  - Curr Opin Organ Transplant. 2016 Aug;21(4):453-8. doi: 
      10.1097/MOT.0000000000000326.