Please use this identifier to cite or link to this item: http://hdl.handle.net/10201/52363

Title: General insufficiency of the classical CDC-based crossmatch to detect donor-specific anti-HLA antibodies leading to invalid results under recipients’ medical treatment or underlying diseases
Issue Date: 2012
Publisher: F. Hernández y Juan F. Madrid. Universidad de Murcia: Departamento de Biología Celular e Histología
Citation: Histology and histopathology, Vol. 27, nº 1 (2012)
ISSN: 1699-5848
0213-3911
Related subjects: CDU::6 - Ciencias aplicadas::61 - Medicina
Keywords: Allograft
Antibodies
Abstract: Antibodies directed against HLA antigen of a given donor represent the most prominent cause for hiper-acute and acute rejections. In order to select recipients without donor-specific antibodies the complement-dependent cytotoxicity (CDC-) crossmatch as the standard procedure was established. As a functional assay it strongly depends on the availability of isolated donor lymphocytes and in particular on their vitality. However, due to several diseases or pharmacological treatment of a given recipient unexpected “false-positive” results of the CDC- crossmatch may arise. We here present three groups of patients which demonstrate the limits of the conventional crossmatch. 1) Kidney recipients before living donations exhibited positive CDC-reactions due to their conditioning using the therapeutical anti-CD20 mAb Rituximab (n=7), routinely used to deplete B-cells, or the anti-CD25 mAb Basiliximab (n=2) to inhibit the proliferation of activated T-cells. 2) Recipients suffering from various leukaemias (n=5) exhibited “positive” CDC-crossmatches using PBL of the donors, although formerly these patients had never shown anti-HLA antibodies. Instead of donor-specific allo-antibodies, cytostatic agents such as 6-Mercaptopurine led to an unspecific cell death. 3) Patients projected for post mortem or living kidney donations (n=44) exhibited “positive” CDC-crossmatch results which were not in accordance with their former antibody status and, partially, with high degrees of HLA-matching. These implausible results were due to underlying auto-immune false-positive B-cell crossmatches by immune diseases, mainly of the systemic Inmune Complex Type III such a Lupus Erythematosus, mainly leading to false-psitive B- cell crossmatches by complexes binding to Fcγ -receptors. In all these 58 cases the alternatively performed ELISA-based “Antibody Monitoring System” (AMS-) crossmatch assay was not artifically affected, suggesting that this assay may be comprehensively established at least for the cases described.
Primary author: Schlaf, Gerald
Mauz-Körholz, Christine
Ott, Undine
Leike, Steffen
Altermann, Wolfgang
URI: http://hdl.handle.net/10201/52363
Document type: info:eu-repo/semantics/article
Number of pages / Extensions: 8
Rights: info:eu-repo/semantics/openAccess
Appears in Collections:Vol.27, nº 1 (2012)

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