title: Excellent results of immunocomplex capture fluorescence analysis-I for cross-match test in renal transplantation.
abstract: A flow cytometry cross-match (FCXM) test is the gold standard for detection of human leukocyte antigen (HLA) antibodies in renal transplantation because of its high sensitivity. However, this technique can produce false-positive results when non-HLA antibodies or low-titer donor-specific antibodies (DSA) are detected. To determine the clinical relevance of the recently introduced novel cross-match test termed immunocomplex capture fluorescence analysis (ICFA), we retrospectively compared the results of ICFA and FCXM, including a single-antigen bead test for detection of DSA in renal transplant recipients. We found a correlation of 71.4% (235/329) between the results of ICFA-I and FCXM-T, whereas that between ICFA-II and FCXM-B was 41.1% (134/326). Ninety-four patients were ICFA-I negative and FCXM-T positive, and 188 were ICFA-II negative and FCXM-B positive, whereas 46.8% (44/94) and 61.7% (116/188) were found to be DSA-I and DSA-II negative, respectively, which classified them into the non-HLA antibody and low-titer DSA groups, respectively. The mean value of molecules of equivalent soluble fluorochrome for DSA-I was 22,994 in the ICFA-I-positive group, which was significantly higher than 2117 in the negative group (P < .0001), whereas there was no significant difference for DSA-II between the ICFA-II-positive and ICFA-II-negative groups. Graft survival in the ICFA-I-negative group was significantly higher than that in the ICFA-I-positive group (P = .0058). Our results indicate that ICFA-I does not respond to non-HLA antibodies or low-titer DSA, which have influence on graft survival. Therefore, this novel hybrid test, which combines cross-match testing and HLA antibody detection functions, may be useful for clinical pretransplantation evaluation of renal transplantation patients.
authors.affiliation: Department of Kidney Transplantation Center, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan. Electronic address: nkennishi3753@nifty.com.
authors.forename: K
authors.initials: K
authors.lastname: Nishimura
authors.affiliation: Department of Kidney Transplantation Center, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Department of Kidney Transplantation Center, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kinoshita
authors.affiliation: Department of Urology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Shiraishi
authors.affiliation: Department of Kidney Transplantation Center, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Ueda
authors.affiliation: Department of Kidney Transplantation Center, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Nakazawa
authors.affiliation: Department of Kidney Transplantation Center, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Hirai
authors.affiliation: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ishimura
authors.affiliation: Department of Kidney Transplantation Center, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kishikawa
authors.affiliation: Department of Urology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nojima
authors.affiliation: Department of Urology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Fujisawa
authors.affiliation: Department of Urology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Shiina
authors.affiliation: Department of Kidney Transplantation Center, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ichikawa
mesh_terms: D005453:Fluorescence; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation