Identification of patients with increased immunological risk among potential kidney recipients in the Polish population.
Pretransplant identification of allosensitized patients is possible thanks to new technologies, which allow for accurate detection of clinically relevant alloantibodies. Implementation of these methods in the screening of patients awaiting transplantation increased their chance for successful donor-recipient matching. Here, 1460 patients reported to the Polish National Waiting List were screened with the Luminex Screen (LS) solid phase test for anti-HLA antibodies. The patients with detected anti-HLA antibodies were assayed with the Luminex Single Antigen (LSA) tests in order to establish defined antigen specificity of the alloantibodies. The results were compared with data on the immunization assessed with the routine complement-dependent-cytotoxicity panel-reactive-antibody assay (PRA CDC). The study showed significantly higher sensitivity of the LS method when compared with PRA CDC. It has been shown that LSA test is a useful technique identifying the specificities of alloantibodies. In particular, LSA allowed to assess donor specific antibodies (DSA) to previous mismatches (MM) and to determine acceptable HLA mismatches of the potential donors. The introduction of solid phase tests in routine pretransplant diagnostics allowed for faster and more accurate assessment of the immunological risk of the recipients and optimal donor-recipient matching. Hence, the presented algorithm of solid phase assays has become a new standard for the identification of allosensitized patients awaiting kidney transplantation in Poland.
Department of Clinical Immunology and Transplantology, Medical University of Gdańsk, Dębinki 7, 80-210 Gdańsk, Poland. Electronic address: gramos@gumed.edu.pl.
Grażyna
G
Moszkowska
Department of Clinical Immunology and Transplantology, Medical University of Gdańsk, Dębinki 7, 80-210 Gdańsk, Poland. Electronic address: hzielinska@uck.gda.pl.
Hanna
H
Zielińska
Department of Clinical Immunology and Transplantology, Medical University of Gdańsk, Dębinki 7, 80-210 Gdańsk, Poland. Electronic address: mzielinski@uck.gda.pl.
Maciej
M
Zieliński
Department of Clinical Immunology and Transplantology, Medical University of Gdańsk, Dębinki 7, 80-210 Gdańsk, Poland. Electronic address: adukat@uck.gda.pl.
Anna
A
Dukat-Mazurek
Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdańsk, Dębinki 7, 80-210 Gdańsk, Poland. Electronic address: adeb@gumed.edu.pl.
Alicja
A
Dębska-Ślizień
Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdańsk, Dębinki 7, 80-210 Gdańsk, Poland. Electronic address: bolo@gumed.edu.pl.
Bolesław
B
Rutkowski
Polish Transplant Coordinating Center "Poltransplant", Al Jerozolimskie 87, 02-001 Warszawa, Poland. Electronic address: dlewandowska@poltransplant.pl.
Dorota
D
Lewandowska
Polish Transplant Coordinating Center "Poltransplant", Al Jerozolimskie 87, 02-001 Warszawa, Poland; Department of Surgical & Transplant Nursing Medical University of Warsaw, ul. Oczki 6, 02-007 Warsaw, Poland. Electronic address: rdanielewicz@poltransplant.pl.
Roman
R
Danielewicz
Department of Clinical Immunology and Transplantology, Medical University of Gdańsk, Dębinki 7, 80-210 Gdańsk, Poland. Electronic address: ptrzon@gumed.edu.pl.
Piotr
P
Trzonkowski
D003601:Cytotoxicity Tests, Immunologic; D005260:Female; D015870:Gene Expression / Q000276:immunology; D005820:Genetic Testing / Q000295:instrumentation / Q000379:methods*; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D007668:Kidney / Q000276:immunology / Q000473:pathology / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D011044:Poland; D051436:Renal Insufficiency, Chronic / Q000276:immunology / Q000473:pathology / Q000601:surgery; D012306:Risk; D014184:Transplantation, Homologous; D061349:Unrelated Donors
D006680:HLA Antigens; D007518:Isoantibodies
Alloantibodies; Highly immunized patients; Luminex; Solid phase assay; Waiting list