title: Lights and shadows of anti-HLA antibodies detected by solid-phase assay.
abstract: Recently, management of patients awaiting solid organ transplantation has taken advantages after the development of more sensitive and accurate solid phase assays which have supported the historic complement dependent cytotoxicity. This approach has allowed the detection of antibodies in patients previously considered negative. The use of the single antigen beads resulted in a more accurate anti-human leukocyte antigen (HLA) antibody characterization. The detection of anti-HLA antibodies specific for C, DQ and DP loci that were not so well characterized has been possible through the implementation of the single antigen assay. The assessment of HLA compatibility has been expanded through the introduction of "epitope matching" concept and the definition of the unacceptable antigens for a more adequate evaluation of donor-recipient compatibility. However, the clinical impact of pre-formed and de novo anti-HLA antibodies detected by solid phase assays is still controversial due to the drawback related to result interpretation. Until today, the unresolved issues concern if all antibodies affect the medium and long term clinical outcome. An open debate on the clinical relevance of anti-HLA antibodies detected by single-antigen beads highlights needing to further investigations. Here, we describe the novel applications and the improvements of the solid-phase assay use.
authors.affiliation: U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Piazza L. Miraglia 2, 80138 Naples, Italy. Electronic address: antonietta.picascia@policliniconapoli.it.
authors.forename: Antonietta
authors.initials: A
authors.lastname: Picascia
authors.affiliation: U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Piazza L. Miraglia 2, 80138 Naples, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Sabia
authors.affiliation: U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Piazza L. Miraglia 2, 80138 Naples, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Grimaldi
authors.affiliation: U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Piazza L. Miraglia 2, 80138 Naples, Italy.
authors.forename: Maria Lourdes
authors.initials: ML
authors.lastname: Montesano
authors.affiliation: U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Piazza L. Miraglia 2, 80138 Naples, Italy.
authors.forename: Linda
authors.initials: L
authors.lastname: Sommese
authors.affiliation: Institute of Diagnostic and Nuclear Development (SDN), IRCCS, Via E. Gianturco 113, 80143 Naples, Italy.
authors.forename: Concetta
authors.initials: C
authors.lastname: Schiano
authors.affiliation: U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Piazza L. Miraglia 2, 80138 Naples, Italy; Institute of Diagnostic and Nuclear Development (SDN), IRCCS, Via E. Gianturco 113, 80143 Naples, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Napoli
mesh_terms: D000906:Antibodies / Q000276:immunology*; D000941:Antigens / Q000276:immunology; D000939:Epitopes / Q000276:immunology; D006084:Graft Rejection / Q000276:immunology; D006085:Graft Survival / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology*; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D007518:Isoantibodies / Q000276:immunology*; D016377:Organ Transplantation / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000906:Antibodies; D000941:Antigens; D000939:Epitopes; D006680:HLA Antigens; D007518:Isoantibodies
keywords: Anti-HLA antibody; Antibody-mediated rejection; Epitope-specific antibody; Mean fluorescence intensity; Single-antigen bead; Solid phase assay