title: Methodologies for anti-HLA antibody screening in patients awaiting kidney transplant: a comparative study.
abstract: OBJECTIVE
  The relevance of anti-HLA antibodies in patients awaiting kidney transplants is well recognized. During the past 40 years, kidney transplant candidates have been tested for these antibodies, and the choice of the detection assay has become essential. Recently, the pioneer method, the complement-dependent cytotoxicity, has been integrated but has not been replaced by more-sensitive solid-phase assays, such as the enzyme-linked immunosorbent assay and the bead-based technology (ie, flow cytometry: FlowPRA, and FlowAnalyzer: Luminex).
  
  
  METHODS
  We compared the sensitivity and antibody specificity of these 4 techniques for detecting panel-reactive antibodies in a population of 101 consecutive patients awaiting a renal transplant (which had already resulted positive in a prescreening analysis).
  
  
  RESULTS
  Sera positive for class I and class II antibodies were 62 and 90 as assessed by the complement-dependent cytotoxicity method, 76 and 58 by using enzyme-linked immunosorbent assay, 83 and 65 with Flow-panel-reactive antibodies, and 90 and 79 by Luminex. Luminex gave more positive scores than the others for class I HLA antibodies, whereas complement-dependent cytotoxicity revealed more positives for those of class II.
  
  
  CONCLUSIONS
  Although Luminex appears more efficient among these assays, our results indicate that use of multiple methods is still the best approach for characterizing the immunologic status of these patients.
authors.affiliation: U.O.C. of Immunohematology and Immunology of Transplantation, CRT-AORN Cardarelli, Salvatore Maugeri Foundation, IRCCS, Institute of Telese, 82037, Benevento, IT. pellegrinob.minucci@unina2.it
authors.forename: Pellegrino B
authors.initials: PB
authors.lastname: Minucci
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Grimaldi
authors.forename: Amelia
authors.initials: A
authors.lastname: Casamassimi
authors.forename: Francesco
authors.initials: F
authors.lastname: Cacciatore
authors.forename: Linda
authors.initials: L
authors.lastname: Sommese
authors.forename: Antonietta
authors.initials: A
authors.lastname: Picascia
authors.forename: Marianna
authors.initials: M
authors.lastname: Resse
authors.forename: Chiara
authors.initials: C
authors.lastname: Sabia
authors.forename: Adolfo
authors.initials: A
authors.lastname: Russo
authors.forename: Claudio
authors.initials: C
authors.lastname: Napoli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003601:Cytotoxicity Tests, Immunologic; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D006680:HLA Antigens / Q000097:blood*; D006648:Histocompatibility; D006650:Histocompatibility Testing / Q000379:methods; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D007558:Italy; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014850:Waiting Lists; D055815:Young Adult
chemical_list: D006680:HLA Antigens; D007518:Isoantibodies