Denatured Class I Human Leukocyte Antigen Antibodies in Sensitized Kidney Recipients: Prevalence, Relevance, and Impact on Organ Allocation
Denatured Class I Human Leukocyte Antigen Antibodies in Sensitized Kidney Recipients: Prevalence, Relevance, and Impact on Organ Allocation
复制标题
DOI：
10.1097/tp.0000000000000229
复制
发表时间：
2014-10-15
期刊：
影响因子：
6.2
通讯作者：
Taupin, Jean-Luc
中科院分区：
文献类型：
--
作者：
Visentin, Jonathan;Guidicelli, Gwendaline;Taupin, Jean-Luc
背景。单抗原流珠测定可能会高估致敏作用，因为检测到了识别变性 I 类人类白细胞抗原 (HLA) 的假定不相关的抗体。方法。对 I 类 HLA 单抗原流珠测定呈阳性的 323 名 HLA 致敏肾移植候选者的血清在对珠进行酸处理后重新进行测试。根据处理和未处理珠子的测量荧光强度之间的比率来鉴定变性的 HLA 抗体。进行 T 淋巴细胞流式细胞仪交叉配血来表征这些抗体识别正常细胞上的 HLA 的能力，作为其潜在临床相关性的替代。通过计算的面板反应性抗体评估它们对器官分配的影响。还评估了很大程度上不含变性 HLA 的单抗原流珠 (iBeads) 的效用。 结果。 39% 的患者检测到变性的 HLA 抗体。与抗天然 HLA 抗体相比，它们提供的流式细胞仪交叉匹配阳性率要低得多（16% vs. 83%，P
Background. Single antigen flow beads assays may overestimate sensitization because of the detection of supposedly irrelevant antibodies recognizing denatured class I human leukocyte antigens (HLAs).Methods. Sera of 323 HLA-sensitized kidney transplant candidates positive with a class I HLA single antigen flow beads assay were retested after acid treatment of the beads. Denatured HLA antibodies were identified according to ratio between the measured fluorescence intensity for treated and nontreated beads. T-lymphocyte flow cytometry crossmatches were performed to characterize the ability of these antibodies to recognize HLA on normal cells as a surrogate of their potential clinical relevance. Their impact on organ allocation was evaluated through a calculated panel reactive antibody. The utility of single antigen flow beads largely devoid of denatured HLA (iBeads) was also evaluated.Results. Denatured HLA antibodies were detected in 39% of the patients. They provided much less positive flow cytometry crossmatches than anti-native HLA antibodies (16% vs. 83%, P