PMID- 30507703
OWN - NLM
STAT- MEDLINE
DCOM- 20200115
LR  - 20200115
IS  - 1531-7013 (Electronic)
IS  - 1087-2418 (Linking)
VI  - 24
IP  - 1
DP  - 2019 Feb
TI  - Measuring alloantibodies: a matter of quantity and quality.
PG  - 20-30
LID - 10.1097/MOT.0000000000000593 [doi]
AB  - PURPOSE OF REVIEW: This review describes the utility and limitations of measure 
      for assessing the presence, relative strength, and clinical impact of human 
      leukocyte antigen (HLA) alloantibodies, as well as the other qualitative features 
      of antibodies that are important considerations in assessing patient risk. RECENT 
      FINDINGS: Using MFI as a measure of antibody amount is limited for a variety of 
      reasons. Standardized serum manipulations such as ethylene-diamine-tetra-acetic 
      acid treatment or serum dilution results in better definition of relationships 
      between MFI and antibody titer or complement activation, toward greater alignment 
      in defining positivity. Increased understanding of HLA epitopes has improved the 
      ability to precisely define donor specific HLA antibody (DSA) specificities and 
      the analysis of structural HLA Class II epitope mismatches in donor-recipient 
      pairs may assist in the prevention of de novo DSA development. Studies of 
      antibody isotypes and immunopathological mechanisms underlying graft injury 
      mediated by non-HLA antibodies are expanding the assessemnt of immunological 
      risk. SUMMARY: Careful analysis of both semiquantitative and qualitative 
      properties of donor-specific antibodies continues to improve our ability to study 
      the effects of DSA on clinical outcomes in solid organ transplantation.
FAU - Kiernan, Jeffrey J
AU  - Kiernan JJ
AD  - Regional HLA Laboratory, Laboratory Medicine Program, University Health Network.
FAU - Ellison, Cynthia A
AU  - Ellison CA
AD  - Regional HLA Laboratory, Laboratory Medicine Program, University Health Network.
AD  - Department of Laboratory Medicine and Pathobiology, University of Toronto, 
      Toronto, Canada.
FAU - Tinckam, Kathryn J
AU  - Tinckam KJ
AD  - Regional HLA Laboratory, Laboratory Medicine Program, University Health Network.
AD  - Division of Nephrology, University Health Network.
AD  - Department of Medicine, University of Toronto.
AD  - Department of Laboratory Medicine and Pathobiology, University of Toronto, 
      Toronto, Canada.
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 (Isoantibodies)
SB  - IM
MH  - Female
MH  - Humans
MH  - Isoantibodies/*immunology
MH  - Male
MH  - Organ Transplantation/*methods
MH  - Tissue Donors
EDAT- 2018/12/07 06:00
MHDA- 2020/01/16 06:00
CRDT- 2018/12/04 06:00
PHST- 2018/12/07 06:00 [pubmed]
PHST- 2020/01/16 06:00 [medline]
PHST- 2018/12/04 06:00 [entrez]
AID - 10.1097/MOT.0000000000000593 [doi]
PST - ppublish
SO  - Curr Opin Organ Transplant. 2019 Feb;24(1):20-30. doi: 
      10.1097/MOT.0000000000000593.