title: Interpreting Anti-HLA Antibody Testing Data: A Practical Guide for Physicians.
abstract: The development of sensitive methods for alloantibody detection has been a significant advance in clinical transplantation. However, the complexity of the data from solid phase and crossmatch assays has led to potential confusion about how to use the results for clinical decision making. The goal of this review is to provide a practical guide for transplant physicians for the interpretation of antibody data to supplement consultation with local tissue typing experts. Sources of variability in both the solid phase and crossmatch assay are discussed as are recent data regarding C1q binding antibodies and IgG subclass testing. Although definitive approaches to alloantibody testing are not possible with our current knowledge, we outline a pragmatic approach that we hope will enhance clinical management in this area.
authors.affiliation: 1 William J. von Liebig Transplant Center, Mayo Clinic, Rochester, MN.2 Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
authors.forename: Carrie A
authors.initials: CA
authors.lastname: Schinstock
authors.forename: Manish J
authors.initials: MJ
authors.lastname: Gandhi
authors.forename: Mark D
authors.initials: MD
authors.lastname: Stegall
mesh_terms: D015415:Biomarkers / Q000097:blood; D015922:Complement C1q / Q000276:immunology; D046148:Donor Selection; D006084:Graft Rejection / Q000097:blood / Q000175:diagnosis / Q000276:immunology* / Q000517:prevention & control; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology*; D006648:Histocompatibility; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007518:Isoantibodies / Q000097:blood*; D016377:Organ Transplantation / Q000009:adverse effects*; D011237:Predictive Value of Tests; D011485:Protein Binding; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012698:Serologic Tests; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006680:HLA Antigens; D007074:Immunoglobulin G; D007518:Isoantibodies; D015922:Complement C1q