A novel strategy for the detection and definition of HLA-specific antibodies in patients awaiting renal transplantation.
Conventional testing for HLA-specific antibodies employs complement-dependent cytotoxicity (CDC) which is labour intensive and dependent on a supply of viable lymphocytes. Our strategy to minimise CDC screening is initially to screen sera by ELISA (Quikscreen) to detect HLA Class I-specific antibodies. Negative sera are then screened by flow cytometry (FCS) using lymphoblastoid cell line pools to detect HLA Class II-specific antibodies. Only Quikscreen- or FCS-positive sera are then tested by CDC and, when indicated, with an ELISA kit (PRA-STAT) for specificity definition. Of 3680 sera, 886 (24.1%) were Quikscreen positive. Of the 2794 Quikscreen-negative sera, 374 (13.4%) were FCS positive. Therefore, only 1265 of the 3680 (34.3%) sera contained HLA-specific antibodies requiring specificity definition. This novel screening strategy has significantly reduced the CDC workload of the laboratory whilst enabling the detection of additional HLA-specific antibodies.
Tissue Typing Laboratory, St. Mary's Hospital, Manchester, UK.
J E
JE
Worthington
A
A
Langton
H
H
Liggett
A J
AJ
Robson
S
S
Martin
D000906:Antibodies / Q000097:blood*; D002985:Clinical Protocols; D003168:Complement Fixation Tests; D004797:Enzyme-Linked Immunosorbent Assay; D005434:Flow Cytometry; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D016030:Kidney Transplantation; D011300:Preoperative Care
D000906:Antibodies; D006680:HLA Antigens