title: The Road to HLA Antibody Evaluation: Do Not Rely on MFI.
abstract: Technological advances in HLA laboratory testing undoubtedly improved the sensitivity and specificity of HLA antibody assessment but not without introducing a set of challenges regarding data interpretation. In particular, the introduction of solid-phase single-antigen bead (SAB) antibody assessment brought the belief that mean fluorescence intensity (MFI) was a quantifiable value. As such, MFI levels heavily influenced HLA antibody reporting, monitoring, and clinical practice. However, given that SAB testing was neither intended for nor approved to be quantifiable, is the use of MFI in current clinical and laboratory practice valid? What, if anything, does this numerical value actually reveal about the pathogenic potential of the antibody? What are the pitfalls and caveats associated with reporting MFI? Herein, we travel the road to HLA antibody assessment and explore the reliability of MFI values to make clinical decisions.
authors.affiliation: Department of Pathology, Emory University Hospital, Atlanta, GA.
authors.forename: H C
authors.initials: HC
authors.lastname: Sullivan
authors.affiliation: Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: R S
authors.initials: RS
authors.lastname: Liwski
authors.affiliation: Department of Pathology, Emory University Hospital, Atlanta, GA.
authors.forename: R A
authors.initials: RA
authors.lastname: Bray
authors.affiliation: Department of Pathology, Emory University Hospital, Atlanta, GA.
authors.forename: H M
authors.initials: HM
authors.lastname: Gebel
mesh_terms: D005453:Fluorescence; D006084:Graft Rejection / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology*; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D007518:Isoantibodies / Q000276:immunology*; D016030:Kidney Transplantation / Q000379:methods*
chemical_list: D006680:HLA Antigens; D007518:Isoantibodies
keywords: alloantibody; alloantigen; clinical research/practice; histocompatibility