title: Luminex-based virtual crossmatching for renal transplantation in South Africa.
abstract: BACKGROUND
  Current practice in the Johannesburg renal transplantation programme is to perform a transplant when the patient's complement-dependent cytotoxicity and flow cytometric crossmatches are negative. However, even in patients with negative crossmatches early graft rejections have occurred. We retrospectively evaluated the use of Luminex anti-human leukocyte antigen (HLA) antibody detection technology, often termed 'virtual crossmatching', compared with the flow cytometric crossmatch, for predicting graft outcome in renal transplant patients.
  
  
  METHODS
  Sixty-four recipients were crossmatched against multiple donors during their routine work-up for transplant (111 crossmatches); 17 of these patients received transplants during the study period. Anti-HLA antibody detection was performed using Luminex technology and the results were compared with the flow cytometric crossmatch results and with short-term graft success.
  
  
  RESULTS
  Compared with flow cytometric crossmatch results, the sensitivity and specificity of Luminex virtual crossmatching was 85.7% and 90.7% for the T-cell crossmatch and 100% and 87.2% for the B-cell crossmatch. Both the sensitivity and specificity of Luminex for predicting short-term graft success were 100%.
  
  
  CONCLUSIONS
  Strong evidence is provided that single-antigen assays provide improved sensitivity to detect clinically relevant anti-HLA antibodies and can reliably be used to predict short-term graft success. We recommend incorporation of single-antigen Luminex methodology into the routine work-up algorithm of renal transplant recipients in South Africa.
authors.affiliation: Department of Haematology and Molecular Medicine, University of Witwatersrand and National Health Laboratory Services, Johannesburg. catherine.worsley@nhls.ac.za
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Worsley
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Mayne
authors.forename: Melinda S
authors.initials: MS
authors.lastname: Suchard
mesh_terms: D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology; D003601:Cytotoxicity Tests, Immunologic / Q000379:methods; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D006085:Graft Survival / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology; D006650:Histocompatibility Testing / Q000379:methods* / Q000592:standards; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D012680:Sensitivity and Specificity
chemical_list: D000888:Antibodies, Anti-Idiotypic; D006680:HLA Antigens