Clinical applicability of the immunomagnetic beads technique for serological crossmatching in renal transplantation.
The aim of the present prospective study was to investigate the clinical applicability of the immunomagnetic (IM) beads technique for serological crossmatching (XM) in renal transplantation. The IM XM were read after various periods of incubation, and the results were compared with those obtained by the conventional Kissmeyer-Nielsen (KN) technique. A total of 132 sera from 96 potential recipients were tested against cells from 62 donors. Eight-nine KN T-cell XM-negative renal allograft transplantations were performed, and the IM XM results were related to clinical 3-month follow-up data (incidence of primary non-function, never functioning grafts, graft losses and rejection episodes). The IM technique was clearly more sensitive than KN, and sensitivity increased markedly with increasing duration of incubation. KN-, IM+ reactions were predominantly found among sera from patients with panel-reactive antibodies (PRA, 2p less than 0.01), and thus probably caused by HLA antibodies. However, positive IM XM, appearing after more than 35 min of incubation, did not influence the overall clinical outcome in the observation period. With reading after exactly 35 min of incubation, XM results obtained by IM and KN techniques correlated well. Thus, we believe, that the IM XM technique will be as safe and effective in avoidance of hyperacute rejections as the conventional assay. In the present material, the incidence of primary nonfunction was significantly (2p = 0.0023) higher among PRA+ recipients compared to PRA- patients. To conclude, we recommended the IM technique with reading after exactly 35 min of incubation for easy, fast (70 min) and reliable XM, that is always possible to perform using peripheral blood.
Povlsen
J V
JV
Department of Clinical Immunology, University Hospital of Aarhus, Denmark.
Madsen
M
M
Rasmussen
A
A
Strate
M
M
Graugaard
B H
BH
Birkeland
S A
SA
Hansen
H E
HE
Fjeldborg
O
O
Lamm
L U
LU
D002469:Cell Separation / Q000295:instrumentation / Q000379:methods*; D006084:Graft Rejection / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology*; D006650:Histocompatibility Testing / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007518:Isoantibodies / Q000032:analysis*; D016030:Kidney Transplantation / Q000276:immunology*; D008280:Magnetics; D008863:Microspheres; D011446:Prospective Studies; D014019:Tissue Donors
D006680:HLA Antigens; D007518:Isoantibodies