Publication: Solid phase-based cross-matching for solid organ transplantation: Currently out-of-stock but urgently required for improved allograft outcome
Authors
Schlaf, Gerald ; Bau, Daniela ; Horstmann, Nathalie ; Sawers, Gary ; Altermann, Wolfgang
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Publisher
Universidad de Murcia, Departamento de Biologia Celular e Histiologia
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DOI
https://doi.org/10.14670/HH-18-217
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info:eu-repo/semantics/article
Description
Abstract
Transplant recipients who have undergone
sensitizing events, such as pregnancy, blood transfusion
or previous transplants, frequently develop antibodies
directed against the highly polymorphous human
leukocyte antigen (HLA)-molecules. These pre-formed,
donor-specific antibodies (DSA) present a high risk of
causing organ failure or even complete loss of the
grafted organ as a consequence of antibody-mediated,
hyper-acute or acute allograft rejection. In order to
detect DSA, the so-called functional complement-
dependent lymphocytotoxicity assay (CDC-XM) was
established about 50 years ago. Although effective in
improving the outcome of solid organ allo-grafting, for
the last ten years this assay has been controversially
discussed due to its low sensitivity and especially
because of its high susceptibility to various artificial
factors, which generally do not yield reliable results. As
a consequence, novel immunochemical test systems
have been developed using ELISA- or bead-based solid
phase assays as replacements for the traditional CDC-
based assays. Because these assays are independent of
single or vital cells, which are frequently not available,
they have provided an additional and alternative
diagnostic approach compared with the traditional
CDC-based and flow-cytometric analyses.
Unfortunately, however, the AMS-ELISA (Antibody
Monitoring System), which was the first system to
become commercially available, was recently
discontinued by the manufacturer after seven years of
successful use. Alternative procedures, such as the
AbCross-ELISA, had to be either considerably
modified, or did not yield reliable results, as in the case
of the Luminex-based assay termed DSA. We draw the
conclusion that due to the unique features and fields of
application reviewed here, the implementation of solid
phase cross-matching still represents an urgent
requirement for any HLA-laboratory’s routine tasks
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Citation
Histology and Histopathology Vol. 35, nº9 (2020)
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