C1Q Assay Results in Complement-Dependent Cytotoxicity Crossmatch Negative Renal Transplant Candidates with Donor-Specific Antibodies: High Specificity but Low Sensitivity When Predicting Flow Crossmatch.
The aim of the present study was to describe the association of positive flow cross match (FXM) and C1q-SAB. Methods. In this observational, cross-sectional, and comparative study, patients included had negative AHG-CDC-XM and donor specific antibodies (DSA) and were tested with FXM. All pretransplant sera were tested with C1q-SAB assay. Results. A total of 50 donor/recipient evaluations were conducted; half of them had at least one C1q+ Ab (n = 26, 52%). Ten patients (20.0%) had DSA C1q+ Ab. Twenty-five (50%) FXMs were positive. Factors associated with a positive FXM were the presence of C1q+ Ab (DSA C1q+ Ab: OR 27, 2.80-259.56, P = 0.004, and no DSA C1q+ Ab: OR 5, 1.27-19.68, P = 0.021) and the DSA LABScreen-SAB MFI (OR 1.26, 95% CI 1.06-1.49, P = 0.007). The cutoff point of immunodominant LABScreen SAB DSA-MFI with the greatest sensitivity and specificity to predict FXM was 2,300 (sensitivity: 72% and specificity: 75%). For FXM prediction, DSA C1q+ Ab was the most specific (95.8%, 85-100) and the combination of DSA-MFI > 2,300 and C1q+ Ab was the most sensitive (92.0%, 79.3-100). Conclusions. C1q+ Ab and LABScreen SAB DSA-MFI were significantly associated with FXM. DSA C1q+ Ab was highly specific but with low sensitivity.
Department of Transplantation, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez, Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
José M
0000-0001-7430-702X
JM
Arreola-Guerra
Histocompatibility Laboratory, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez, Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
Natalia
N
Castelán
Histocompatibility Laboratory, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez, Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
Adrián
A
de Santiago
Histocompatibility Laboratory, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez, Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
Adriana
A
Arvizu
Histocompatibility Laboratory, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez, Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
Norma
N
Gonzalez-Tableros
Histocompatibility Laboratory, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez, Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
Mayra
M
López
Histocompatibility Laboratory, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez, Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
Isaac
I
Salcedo
Department of Transplantation, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez, Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
Mario
M
Vilatobá
Department of Transplantation, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez, Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
Julio
J
Granados
Department of Nephrology-Mineral Metabolism, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez, Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
Luis E
0000-0002-7227-484X
LE
Morales-Buenrostro
Department of Transplantation, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez, Sección XVI, Tlalpan, 14080 Mexico City, Mexico.
Josefina
0000-0002-8271-1353
J
Alberú
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