© 2018 Wolters Kluwer Abstract S213
425.4
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Conclusion: In a low immunological risk population of patients waiting for a
transplant, definition of HLA sensitization is highly dependent on the solid
phase assay technique and the threshold chosen. The correlation between
Luminex screening and SA is significant only for screening ratios above the
median value. The predictive value of screening tests regarding results of
SA is low to moderate and optimal thresholds are different for class 1 and 2.
This study was realized with the financial support of Assistance Publique
Hôpitaux de Paris, Sandoz and CSL Behring France.
Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
Unmasking Uncertain Results after Anti-HLA Antibody Screening
in Patients on Waiting List
Laura Riesco1,2, Juan Irure1,2, Rosa Palomar3, Celestino Piñera3,
Emilio Rodrigo3, Marcos López-Hoyos1,2, David San Segundo1,2
1
Immunology, Universitary Hospital Marqués de Valdecilla-IDIVAL,
Santander, Spain; 2Tissue Typing Laboratory, Universitary Hospital
Marqués de Valdecilla, Santander, Spain; 3Nephrology, Universitary
Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.
Introduction: Since the implementation of Luminex for anti-HLA testing, the
improvement in the definition of anti-HLA patterns is clear. However, several
caveats should be taken into account such as false positive and negative re-
sults due to technical issues, denatured molecules, cross-reaction, lack of
cut-off consensus, wide inter- and intra-assay variability, prozone effect, inter-
ference with complement. The aim of the study is to improve the definition of
anti-HLA results after Luminex assay.
Material and Methods: 37 patients were listed in our institution and tested
for anti-HLA antibodies both screening and Single Antigen bead (SAB) as-
says (LABScreen Mixed and LABScreen Single Antigen, One Lambda,
CA). Acid treatment of the beads was performed to identify reactions
against denatured-HLA (dHLA) or native-HLA (nHLA) molecule and further
complement-dependent (CDC) and flow cytometry cross-match (FCXM)
tests to confirm dHLA or nHLA reactions.
Results and Discussion: In 21 (57.7%) listed patients, specific reactions
with negative screening with SAB Positive results were found. The MFI in
the specific reaction was significantly increased in SAB vs screening (4949
∓ 3030 vs 154 ∓ 87, p<0.001). After acid treatment of the beads, 65% of the
reactions against (dHLA) were identified. Moreover, the negative results after
CDC and FCXM were confirmed. Performing SAB assay in unsensitized pa-
tients in waiting list identify reactions against dHLA molecule without rele-
vance in cross-match.
FIGURE 1.
Conclusion: Acid treatment of the beads allows the identification of dHLA
and should be performed to improve the accuracy in anti-HLA antibody
assignment.
ISCiiI and FEDER, REDinREN RD16/0009/0027.