Improvement in the definition of anti-HLA antibody profile in highly sensitized patients.
The definition of anti-HLA antibody profile in highly sensitized patients on a waiting list is crucial when virtual crossmatch is used in organ allocation systems, but also when used to identify the true deleterious anti-HLA antibodies. Here we propose different levels of risk based on the results of anti-HLA antibody testing in neat serum (N) and after sera dilution (DIL) and C1q test in 18 highly sensitized patients. This group was heterogeneous in terms of anti-HLA antibody titers and their ability to fix complement. After dilution, 15 out of 18 patients (83.3%) showed a reduction of positive bead counts whereas 4 patients showed a prozone effect and complement fixation was demonstrated. The high dilution of sera and ascertaining the complement fixation allow the accurate definition of risk anti-HLA antibody profiles in highly sensitized patients, as demonstrated in 5 of the sensitized patients who were transplanted.
Immunology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.|Tissue Typing Laboratory, University Hospital Marqués de Valdecilla, Santander, Spain.
Juan
J
Irure
Immunology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.|Tissue Typing Laboratory, University Hospital Marqués de Valdecilla, Santander, Spain.
Esther
E
Asensio
Nephrology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.
Emilio
E
Rodrigo
Tissue Typing Laboratory, University Hospital Marqués de Valdecilla, Santander, Spain.
Íñigo
Í
Romón
Pathology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.
Javier
J
Gómez
Nephrology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.
Manuel
M
Arias
Immunology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.|Tissue Typing Laboratory, University Hospital Marqués de Valdecilla, Santander, Spain.
Marcos
M
López-Hoyos
Immunology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.|Tissue Typing Laboratory, University Hospital Marqués de Valdecilla, Santander, Spain.
David
http://orcid.org/0000-0001-5745-9072
D
San Segundo
D000920:Antibody-Dependent Cell Cytotoxicity; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D015331:Cohort Studies; D003167:Complement Activation; D015922:Complement C1q / Q000276:immunology; D005260:Female; D005434:Flow Cytometry; D006680:HLA Antigens / Q000276:immunology*; D006650:Histocompatibility Testing / Q000379:methods; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008297:Male; D008875:Middle Aged
D001323:Autoantibodies; D006680:HLA Antigens; D015922:Complement C1q