Luminex Solid-Phase Crossmatch for De Novo Donor-Specific Antibodies in Living-Donor Related Transplants

• Published in: Experimental and clinical transplantation Vol. 15; no. 4; pp. 394 - 399
• Main Authors: Mehrotra, Sonia, Sharma, Raj Kumar, Mayya, Mahabaleshwar, Gupta, Amit, Prasad, Narayan, Kaul, Anupma, Bhadauria, Dharmendra Singh
• Format: Journal Article
• Language: English
• Published: Turkey Başkent Üniversitesi 01-08-2017
• Subjects: Biomarkers - blood; Cytotoxicity, Immunologic; Family; Glomerulonephritis - immunology; Graft Rejection - immunology; Graft Survival; Histocompatibility; Histocompatibility Testing; HLA Antigens - immunology; Humans; Immunosuppressive Agents - therapeutic use; Isoantibodies - blood; Kidney Transplantation - adverse effects; Kidney Transplantation - methods; Living Donors; Predictive Value of Tests; Prospective Studies; Risk Factors; Time Factors; Tıp; Treatment Outcome; Ankara; Türkiye; Antibodymediated rejection; Sensitivity and specificity; T-cell mediated rejection; Single antigen bead assay; Acute transplant rejection
• ISSN: 1304-0855; 2146-8427
• DOI: 10.6002/ect.2016.0178

There are no reports of de novo donor-specific antibody monitoring by a low-cost solid-phase crossmatch assay using donor lysate after renal transplant.
We prospectively evaluated 121 complement-dependant cytotoxicity crossmatch-negative living-donor kidney transplant recipients for development of de novo donor-specific antibodies (class I and II HLA) by solid-phase crossmatch Luminex assay after transplant.
Of 121 recipients in our study group, 26 (21.5%) developed de novo donor-specific antibody within 3 months after transplant. Fifteen (58%) of these 26 recipients developed class II de novo donor-specific antibody, 8 patients (30%) developed class I, and 3 (12%) developed both class I and class II. Of the remaining 95 patients (79%) who did not develop de novo donor-specific antibody, 6 (33.3%) had antibody-mediated rejection with glomerulitis (2 with C4d-positive disease). Donor-specific antibody was detected by Luminex solid-phase crossmatch in 18 patients (5 with class I, 11 with class II, and 2 with both class I and II), all with no evidence of clinical rejection. Development of de novo donor-specific antibody detected by solid-phase crossmatch was associated with more acute rejection (31% in de novo donor-specific antibody-positive group versus 19% in the negative group). The positive group had more antibody-mediated rejection (75% of acute rejections), whereas only 33.3% of acute rejections in the negative group were antibody-mediated rejection. Of 12 patients with antibody-mediated rejection, 9 were C4d negative (75%) and were diagnosed by donor-specific antibody positivity detected by solid-phase cros?match testing and histologic findings. The use of donor lysate in solid-phase crossmatch assays is more economical than the single-antigen bead Luminex assay (per test cost of US $45.20 vs $403.20).