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Cross-reactivity00:42

Cross-reactivity

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Updated: May 17, 2026

Personalized Peptide Arrays for Detection of HLA Alloantibodies in Organ Transplantation
08:07

Personalized Peptide Arrays for Detection of HLA Alloantibodies in Organ Transplantation

Published on: September 6, 2017

Modified solid-phase alloantibody detection for improved crossmatch prediction.

Markus Wahrmann1, Gerald Hlavin, Gottfried Fischer

  • 1Division of Nephrology and Dialysis, Department of Medicine III, Medical University Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. markus.wahrmann@meduniwien.ac.at

Human Immunology
|October 18, 2012
PubMed
Summary
This summary is machine-generated.

Modified single-antigen bead assays, particularly detecting complement-activating donor-specific antibodies (C4d-DSA), significantly improve virtual crossmatch accuracy for predicting complement-dependent cytotoxicity crossmatch outcomes in organ transplantation.

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Area of Science:

  • Transplantation immunology
  • Immunogenetics
  • Clinical diagnostics

Background:

  • Virtual crossmatching using single-antigen bead (SAB) assays for donor-specific antibodies (DSA) has limitations in predicting complement-dependent cytotoxicity crossmatch (CDCXM) results.
  • Accurate prediction of CDCXM outcomes is crucial for successful organ transplantation and reducing rejection rates.

Purpose of the Study:

  • To evaluate modified SAB assays for improved prediction of T-cell and B-cell CDCXM outcomes.
  • To assess the efficacy of detecting complement-activating DSA (C4d-DSA) and DSA with abrogated prozone effect (IgG/DTT-DSA) in virtual crossmatching.

Main Methods:

  • Analysis of 672 crossmatch combinations from 32 highly sensitized patients against cells from 21 individuals.
  • Modification of SAB assays to include C4d-fixation ([C4d]DSA) and dithiotreitol addition ([IgG/DTT]DSA).
  • Receiver operating characteristic (ROC) analysis to determine the predictive accuracy (Area Under the Curve - AUC) of different assay modifications for T-cell and B-cell CDCXM.

Main Results:

  • [C4d]DSA detection demonstrated superior predictive accuracy for T-cell CDCXM (AUC=0.81) compared to other parameters.
  • [IgG/DTT]DSA (AUC=0.77) and [IgG]DSA (AUC=0.72) showed lower predictive values.
  • [C4d]DSA was also more effective for predicting B-cell CDCXM, though specificity decreased at very low thresholds.
  • Combining classifiers ([C4d] plus [IgG/DTT]) slightly improved AUC to 0.82 for T-cell CDCXM.

Conclusions:

  • Solid-phase complement detection ([C4d]DSA) is highly efficient for virtual crossmatching, significantly enhancing the prediction of CDCXM outcomes.
  • While B-cell CDCXM prediction is less precise, adjusting CDCXM thresholds can improve accuracy.
  • Modified SAB assays, especially those detecting complement activation, offer a valuable tool for improving pre-transplant compatibility assessment.