Interpretation of Positive Flow Cytometric Crossmatch in the Era of the Single-Antigen Bead Assay

@article{Couzi2011InterpretationOP,
  title={Interpretation of Positive Flow Cytometric Crossmatch in the Era of the Single-Antigen Bead Assay},
  author={Lionel Couzi and Caroline Araujo and Gwendaline Guidicelli and Thomas Bachelet and Karine Moreau and Delphine Morel and Gr{\'e}goire Robert and Hervé Wallerand and Jean François Moreau and Jean-Luc Taupin and Pierre Merville},
  journal={Transplantation},
  year={2011},
  volume={91},
  pages={527-535}
}
Background. Prognosis of renal transplants with positive flow cytometric crossmatch (FCXM) remains controversial. Methods. We analyzed the outcome of these kidney transplant recipients by human leukocyte antigen (HLA) donor-specific antibodies (HLA-DSA) using single-antigen bead (SAB) assays in major histocompatibility complex classes I and II. We compared them with controls with a negative FCXM. Results. Forty-five patients consecutively transplanted with a positive FCXM had significantly more… 
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80 Citations
Background Citations
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Methods Citations
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Results Citations
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Combining Sensitive Crossmatch Assays With Donor/Recipient Human Leukocyte Antigen Eplet Matching Predicts Living-Donor Kidney Transplant Outcome
Pre-transplant donor specific antibody and its clinical significance in kidney transplantation.
TLDR
There was a higher incidence of AMR in patients with pre-transplant DSA despite a negative CDC crossmatch, however, pre- transfusion DSA detected by Luminex had no statistically significant impact on delayed graft function, patient survival and graft survival.
Predictive Potential of Flow Cytometry Crossmatching in Deceased Donor Kidney Transplant Recipients Subjected to Peritransplant Desensitization
TLDR
It is suggested that pretransplant FCXM and DSA number, but not DSA MFI, are independent predictors of ABMR in patients who received peritransplant desensitization.
Positive Luminex and negative flow cytometry in kidney transplantation: a systematic review and meta-analysis.
TLDR
Current evidence suggests that low-level DSA detected by Luminex alone does not pose significant risk at least in the short-medium term, and the avoidance of PLNF transplants may be unwarranted especially in patients who have been enlisted for a long time.
Donor-specific antibodies adversely affect kidney allograft outcomes.
TLDR
The results of a systematic review and meta-analysis of rejection rates and graft outcomes for renal transplant recipients with such preformed DSAs, defined by positive results on SPA but negative complement-dependent cytotoxicity and flow cytometry crossmatch results, suggest that donor selection should consider the presence of antibodies in the recipient, identified by the SPA, even in the absence of a negative flow cytometer crossmatch result.
The disappointing contribution of anti-human leukocyte antigen donor-specific antibodies characteristics for predicting allograft loss
  • Maxime Courant, J. Visentin, +7 authors J. Taupin
  • Medicine
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 2018
TLDR
The findings weaken the rationale for systematically implementing C1q, C3d or gDSA assays in this situation, because they do not independently predict ABMR and graft loss.
Pretransplant anti-HLA-Cw and anti-HLA-DP antibodies in sensitized patients.
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
TLDR
C1q-SAB and LABScreen SAB DSA-MFI were significantly associated with FXM and DSA C1q+ Ab was highly specific but with low sensitivity.
Clinical Significance of Pretransplant Donor‐Specific Antibodies in the Setting of Negative Cell‐Based Flow Cytometry Crossmatching in Kidney Transplant Recipients
  • O. Adebiyi, J. Gralla, +4 authors J. Cooper
  • Medicine, Biology
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2016
TLDR
Pretransplant DSA in the setting of a negative FCXM confers minimal immunologic risk in the intermediate term, does not necessitate desensitization therapy and should not represent a barrier to renal transplant.
Comparative Assessment of Anti-HLA Antibodies Using Two Commercially Available Luminex-Based Assays
TLDR
Immucor and One Lambda/ThermoFisher assays have a similar, albeit nonidentical, ability to detect anti-HLA Ab; although the correlation between the assays was present, significant variances exist, some of which can be explained by a dilution-sensitive “prozone” effect.
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References

SHOWING 1-10 OF 44 REFERENCES
Clinical Relevance of Pretransplant Donor-Specific HLA Antibodies Detected by Single-Antigen Flow-Beads
TLDR
The results support the utility of SAFB for pretransplant risk assessment and organ allocation, and suggest that improvement of the positive predictive value of HLA-DSA defined by SAFB will require an enhanced definition of pathogenic factors of HBA.
Improved Graft Survival in Highly Sensitized Patients Undergoing Renal Transplantation After the Introduction of a Clinically Validated Flow Cytometry Crossmatch
TLDR
It is demonstrated that prospective FCXM improves renal transplant outcome in highly sensitized patients, provided that cut-off values are carefully validated and results interpreted in the context of sensitization history and antibody screening results.
THE SIGNIFICANCE OF A POSITIVE FLOW CYTOMETRY CROSSHATCH TEST IN PRIMARY KIDNEY TRANSPLANTATION
TLDR
It is suggested that flow cytometry crossmatching (FCXM) be used prospectively, despite the fact that many patients with a positive crossmatch did have successful transplants (TXs), because of the high number of patients with complement-fixing antibodies.
Pretransplant Donor-Specific Antibodies in Cytotoxic Negative Crossmatch Kidney Transplants: Are They Relevant?
TLDR
Data show that in the context of a CDC-negative crossmatch, the presence of D0 DSA has little impact on any early graft parameters, however, DSA are associated with poorer longer-term graft outcomes in kidney transplantation.
Clinical Relevance of Pretransplant Donor-Directed Antibodies Detected by Single Antigen Beads in Highly Sensitized Renal Transplant Patients
TLDR
It was showed that in the AM program DDA detected by SA, and not by less-sensitive methods, may be related to acute rejection episodes but is not detrimental to long-term graft outcome, raising questions about the increasing use of more-sensitive screening techniques for the allocation of organs.
Kidney Transplantation in Patients with Antibodies against Donor HLA Class II
  • H. Pollinger, M. Stegall, +4 authors W. Park
  • Medicine, Biology
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2007
TLDR
It is concluded that KTx recipients with clearly defined anti‐Class II DSA are at risk for humoral rejection suggesting that desensitization and/or close posttransplant monitoring may be needed to prevent AMR.
Flow cytometry-detected IgG is not a contraindication to renal transplantation: IgM may be beneficial to outcome.
TLDR
Evaluating the impact of a positive FCXM on the rejection frequency and 1-year graft survival for cyclosporine-prednisone-treated primary (haplo-ID and CAD) renal allograft recipients suggests that the presence of IgM may be beneficial in reducing the occurrence of rejection episodes and improving graft survivals.
Relevance of different antibody detection methods for the prediction of antibody-mediated rejection and deceased-donor kidney allograft survival.
Preexisting donor-specific HLA antibodies predict outcome in kidney transplantation.
TLDR
In conclusion, the risk for both AMR and graft loss directly correlates with peak HLA-DSA strength, which should help guide selection of acceptable grafts for sensitized patients.
Anti‐HLA Donor‐Specific Antibodies Detected in Positive B‐Cell Crossmatches by Luminex® Predict Late Graft Loss
  • H. Eng, G. Bennett, +5 authors G. Russ
  • Medicine, Biology
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2008
TLDR
Using BXM to preclude kidney transplantation may potentially disadvantage >60% of patients in whom BXM is not indicative of the presence of DSA, as only one‐third of positive B‐cell crossmatch (BXM) was caused by DSA and was associated with late graft loss.
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