title: Strength of donor-specific antibodies with the use of Luminex single-antigen beads is a reliable predictor of acute rejection in living-relative kidney recipients.
abstract: BACKGROUND
  Luminex single-antigen assay is a promising technique for determination of donor-specific antibodies (DSAs) in renal transplantation.
  
  
  METHODS
  Serum samples from living-relative renal recipients before and after renal transplantation were examined with the use of Luminex single-antigen assay. The impact of de novo DSAs on the early clinical outcomes of renal allograft was analyzed.
  
  
  RESULTS
  Of the 61 patients included, 15 patients (24.6%) presented de novo DSA (4 class I, 4 class II, and 7 both classes) after transplantation, and the average (median) cumulative strength of DSA was 1,283 (range, 0-10,802) mean fluorescence index (MFI) for class I versus 1,324 (range, 0-14,985) MFI for class II (P > .05). Twelve (19.7%) of the 61 patients experienced a clinical/subclinical acute rejection (AR) episode within the 1st 2 years after transplantation. A clinical/subclinical AR episode was diagnosed in 40% of DSA(+) patients and 13.0% of DSA(-) patients (P < .05). DSA(+) patients who developed an AR episode had a higher mean cumulative MFI value (8,118.3 ± 5,287.4; range, 1,785-14,985) than patients who did not develop an AR episode (3,283.7 ± 2,601.0; range, 786-8,113; P < .05). Serum creatinine levels in the DSA(+) group were significantly higher than in the DSA(-) group at 12 and 24 months after transplantation. The graft survival rates at 2 years in the DSA(+) and DSA(-) groups were not different (86.7% vs 91.3%; P > .05).
  
  
  CONCLUSIONS
  Patients with de novo DSAs at high strength may suffer a high risk of developing an AR episode. Therefore, careful monitoring of de novo DSAs with the use of Luminex single-antigen beads may help in early intervention for AR in renal allografts and to minimize renal damage caused by the antibodies.
authors.affiliation: Organ Transplant Institution, Fujian Provincial Key Laboratory of Transplant Biology, Fuzhou General Hospital, Xiamen University, Fuzhou, People's Republic of China.
authors.forename: M Y
authors.initials: MY
authors.lastname: Tang
authors.affiliation: Organ Transplant Institution, Fujian Provincial Key Laboratory of Transplant Biology, Fuzhou General Hospital, Xiamen University, Fuzhou, People's Republic of China.
authors.forename: Q H
authors.initials: QH
authors.lastname: Wang
authors.affiliation: Organ Transplant Institution, Fujian Provincial Key Laboratory of Transplant Biology, Fuzhou General Hospital, Xiamen University, Fuzhou, People's Republic of China.
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.affiliation: Organ Transplant Institution, Fujian Provincial Key Laboratory of Transplant Biology, Fuzhou General Hospital, Xiamen University, Fuzhou, People's Republic of China.
authors.forename: X
authors.initials: X
authors.lastname: Gao
authors.affiliation: Organ Transplant Institution, Fujian Provincial Key Laboratory of Transplant Biology, Fuzhou General Hospital, Xiamen University, Fuzhou, People's Republic of China.
authors.forename: L
authors.initials: L
authors.lastname: Wu
authors.affiliation: Organ Transplant Institution, Fujian Provincial Key Laboratory of Transplant Biology, Fuzhou General Hospital, Xiamen University, Fuzhou, People's Republic of China. Electronic address: doctortjm@yahoo.com.
authors.forename: J M
authors.initials: JM
authors.lastname: Tan
mesh_terms: D000328:Adult; D000906:Antibodies / Q000097:blood*; D005260:Female; D006084:Graft Rejection / Q000097:blood* / Q000209:etiology*; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology*; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D007668:Kidney / Q000276:immunology; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D000906:Antibodies; D006680:HLA Antigens