title: Pretransplantation monitoring of HLA antibodies by complement dependent cytotoxicity and Luminex-based assays.
abstract: BACKGROUND
  The introduction of more sensitive techniques, such as Luminex® for HLA antibody screening of patients awaiting organ transplantation has resulted in a better understanding of transplantation immunology and improvements in clinical practice.
  
  
  OBJECTIVE
  The interpretation of the results obtained only by Luminex® can lead to inaccurate evaluation of a patient's antibody status and unjustified rejection of a potential organ donor. The aim of this study was to demonstrate the benefits of performing HLA antibody screening in the sera of patients on the waiting list for organ transplantation by two different assays, complement dependent cytotoxicity (CDC) and Luminex®.
  
  
  METHODS
  A retrospective analysis was performed on 563 pretransplant serum samples from 141 patients on the kidney transplantation waiting list in Rijeka, tested from March 2012 until March 2015. All samples were tested in parallel by the CDC assay and the Luminex®-based assay.
  
  
  RESULTS
  Out of the 563 samples tested 302 (53.7%) tested negative for HLA antibodies and 88 (15.6%) positive by both assays. From 173 (30.7%) samples with discordant results 149 (26.5%) were CDC negative and Luminex® positive, while 24 (4.3%) were CDC positive and Luminex® negative. Among the Luminex positive patients seven did not experience any immunizing events.
  
  
  CONCLUSIONS
  Evaluation of the HLA antibody status in patients on a waiting list for organ transplantation should be based on the results of the both CDC and Luminex® (or other sensitive) assays in accordance to information about patient's clinical status and exposure to immunizing events.
authors.affiliation: Tissue Typing Laboratory, Clinical Institute for Transfusion Medicine, Clinical Hospital Center Rijeka, Tome Strižića 3, 51 000, Rijeka, Croatia. tipizacija@kbc-rijeka.hr.
authors.forename: Nataša
authors.identifier: http://orcid.org/0000-0002-2742-9275
authors.initials: N
authors.lastname: Katalinić
authors.affiliation: Tissue Typing Laboratory, Clinical Institute for Transfusion Medicine, Clinical Hospital Center Rijeka, Tome Strižića 3, 51 000, Rijeka, Croatia.
authors.forename: Marina
authors.initials: M
authors.lastname: Fućak
authors.affiliation: Tissue Typing Laboratory, Clinical Institute for Transfusion Medicine, Clinical Hospital Center Rijeka, Tome Strižića 3, 51 000, Rijeka, Croatia.
authors.forename: Tajana
authors.initials: T
authors.lastname: Crnić
authors.affiliation: Tissue Typing Laboratory, Clinical Institute for Transfusion Medicine, Clinical Hospital Center Rijeka, Tome Strižića 3, 51 000, Rijeka, Croatia.
authors.forename: Milena
authors.initials: M
authors.lastname: Ćurković
authors.affiliation: Tissue Typing Laboratory, Clinical Institute for Transfusion Medicine, Clinical Hospital Center Rijeka, Tome Strižića 3, 51 000, Rijeka, Croatia.
authors.forename: Alma
authors.initials: A
authors.lastname: Starčević
authors.affiliation: Tissue Typing Laboratory, Clinical Institute for Transfusion Medicine, Clinical Hospital Center Rijeka, Tome Strižića 3, 51 000, Rijeka, Croatia.|Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
authors.forename: Sanja
authors.initials: S
authors.lastname: Balen
mesh_terms: D015938:Complement Membrane Attack Complex / Q000276:immunology*; D006084:Graft Rejection / Q000209:etiology / Q000276:immunology* / Q000517:prevention & control*; D006680:HLA Antigens / Q000276:immunology*; D006648:Histocompatibility / Q000276:immunology; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D007118:Immunoassay / Q000379:methods; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D008163:Luminescent Measurements / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D015938:Complement Membrane Attack Complex; D006680:HLA Antigens
keywords: Antibodies; Cytotoxicity test; Histocompatibility antigens; Histocompatibility testing; Kidney transplantation