title: Flow cytometry beads rather than the antihuman globulin method should be used to detect HLA Class I IgG antibody (PRA) in cadaveric renal regraft candidates.
abstract: HLA Class I antibody screening can be performed by flow cytometry using a mixture of 30 distinct bead populations each coated with the Class I antigen phenotype derived from different cell lines. In this study we compared the efficacy of Class I antibody screens done by flow cytometry beads with the antihuman globulin (AHG) method for patients awaiting cadaveric renal retransplantation. Class I panel reactive antibody (PRA) screening by flow cytometric beads of 21 regraft serum samples that had all been found to be negative by AHG DTT Class I PRA, revealed that 57.1% (12 of 21) had a flow Class I PRA of > or = 10%. Furthermore, when five regraft sera with an intermediate PRA were screened (mean AHG DTT PRA = 33.2 +/- 13%) the mean flow Class I PRA almost doubled (mean flow PRA = 72.4 +/- 10.2%) (p < 0.01). When active UNOS waiting list regraft candidates, after several months of screening the Class I PRA by flow beads, were divided into the three PRA categories based on their peak flow Class I PRA value (0-20%, 21-79% and > or = 80%), the incidence of a positive flow cross-match was 0%, 72% and 85% and the incidence of retransplantation was 60%, 22% and 10%, in each of these groups, respectively. These data provided our histocompatibility laboratory with the rationale to stop performing the AHG PRA and perform only the flow Class I PRA method for regraft candidates.
authors.affiliation: Midwest Transplant Network, Westwood, KS 66205, USA.
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Bryan
authors.forename: Scott B
authors.initials: SB
authors.lastname: McDonald
authors.forename: Karen A
authors.initials: KA
authors.lastname: Baier
authors.forename: Alan M
authors.initials: AM
authors.lastname: Luger
authors.forename: Mark I
authors.initials: MI
authors.lastname: Aeder
authors.forename: Daniel
authors.initials: D
authors.lastname: Murillo
authors.forename: Nicolas A
authors.initials: NA
authors.lastname: Muruve
authors.forename: Paul W
authors.initials: PW
authors.lastname: Nelson
authors.forename: Charles F
authors.initials: CF
authors.lastname: Shield
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Warady
mesh_terms: D003298:Coombs Test; D003601:Cytotoxicity Tests, Immunologic; D005434:Flow Cytometry / Q000379:methods; D015395:Histocompatibility Antigens Class I / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D016030:Kidney Transplantation / Q000276:immunology*; D012086:Reoperation
chemical_list: D015395:Histocompatibility Antigens Class I; D007074:Immunoglobulin G