title: Modified flow cytometry crossmatch detecting alloantibody-related cytotoxicity as a way to distinguish lytic antibodies from harmless in allosensitised kidney recipients.
abstract: The serological complement-dependent cytotoxicity crossmatch (CDC-XM) permits routine identification of anti-donor alloantibodies in the sera of allotransplant recipients. However, in a small group of recipients, antibodies below the threshold of detection may still be responsible for hyperacute rejection. For the same reason, approximately 20% of recipients develop acute rejection episodes. The flow cytometry crossmatch (FCXM) was designed to address these problems, but because of the presence of clinically insignificant antibodies (linked, non-lytic), the FCXM appears to be too sensitive yielding false-positive results. We compared FCXM with its modified version assessing cell viability (cytolytic flow cytometry crossmatch; cFCXM) using sera from previously sensitised kidney recipients. The presence of alloantibodies was detected using the Luminex platform. The cFCXM proved to be of greater sensitivity than CDC-XM, which was additionally confirmed with bead-based Luminex techniques. The cFCXM was also superior to FCXM because it distinguished lytic from non-lytic antibodies. The cFCXM was superior to assess donor specificity, sensitivity, and detection of clinically relevant lytic antibodies.
authors: Department of Clinical Immunology and Transplantology, Medical University of Gdańsk, Gdańsk, Poland. mzielinski@gumed.edu.pl
authors: M
authors: M
authors: Zieliński
authors: H
authors: H
authors: Zielińska
authors: G
authors: G
authors: Moszkowska
authors: A
authors: A
authors: Dȩbska-Ślizień
authors: B
authors: B
authors: Rutkowski
authors: P
authors: P
authors: Trzonkowski
mesh_terms: D000906:Antibodies / Q000276:immunology*; D000941:Antigens / Q000276:immunology; D002470:Cell Survival; D003165:Complement System Proteins; D003601:Cytotoxicity Tests, Immunologic; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D006084:Graft Rejection / Q000276:immunology; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007518:Isoantibodies / Q000097:blood / Q000276:immunology*; D007668:Kidney / Q000276:immunology; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods*; D008214:Lymphocytes / Q000166:cytology; D008297:Male; D012086:Reoperation
chemical_list: D000906:Antibodies; D000941:Antigens; D006680:HLA Antigens; D007074:Immunoglobulin G; D007518:Isoantibodies; D003165:Complement System Proteins