Review article
https://doi.org/10.21860/medflum2020_245221
Pre-transplant monitoring of HLA antibodies performed by Luminex-based assays
Nataša Katalinić
orcid.org/0000-0002-2742-9275
; Klinički zavod za transfuzijsku medicinu, Klinički bolnički centar Rijeka, Rijeka, Hrvatska, Medicinski fakultet Sveučilišta u Rijeci, Rijeka, Hrvatska
Tajana Crnić Marčetić
; Medicinski fakultet Sveučilišta u Rijeci, Rijeka, Hrvatska
Sanja Balen
orcid.org/0000-0003-2408-6868
; Klinički zavod za transfuzijsku medicinu, Klinički bolnički centar Rijeka, Rijeka, Hrvatska, Medicinski fakultet Sveučilišta u Rijeci, Rijeka, Hrvatska
Abstract
Human Leucocyte Antigen (HLA) alloimmunization is one of the most significant immune factors affecting the outcome of a kidney transplantation. Therefore, a sera screening and identification of antibody specificity are an extremely important part of the immunogenetic assessment of a potential organ recipient. In recent decades, the complement-dependent lymphocytotoxicity (CDC) assay has been the “gold standard” to detect and identify HLA antibodies. However, the low sensitivity of this method has encouraged the development of new techniques such as flow cytometry and solid phase techniques among which the highest sensitivity and specificity has been achieved with the Luminex technology. At the Tissue Typing Laboratory Rijeka, the screening of patients’ sera is performed in parallel with the CDC method and the Luminex technique, the characteristics of which are presented in this paper. With many advantages, the Luminex technique has several limitations that make the interpretation of test results complex and demanding. Therefore, the determination of clinically relevant HLA antibodies is based on the test results of both, CDC and Luminex technique. It involves number of factors that require close collaboration between tissue typing laboratory staff and clinicians based on individual patient assessment. Despite many challenges, the introduction of the Luminex technique into the screening of recipients’ serum has enabled to gain new insights into the importance and role of HLA antibodies in graft rejection and has brought some important changes in clinical transplant medicine.
Keywords
antibodies; histocompatibility; human leukocyte antigens; immunization; kidney transplantation; Luminex
Hrčak ID:
245221
URI
Publication date:
1.12.2020.
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