Improvement in the definition of anti-HLA antibody profile in highly sensitized patients

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Personalized Peptide Arrays for Detection of HLA Alloantibodies in Organ Transplantation
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Juan Irure1,2, Esther Asensio1,2, Emilio Rodrigo3

  • 1Immunology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.

Plos One
|February 4, 2017
PubMed

The definition of anti-HLA antibody profile in highly sensitized patients on a waiting list is crucial when virtual crossmatch is used in organ allocation systems, but also when used to identify the true deleterious anti-HLA antibodies. Here we propose different levels of risk based on the results of anti-HLA antibody testing in neat serum (N) and after sera dilution (DIL) and C1q test in 18 highly sensitized patients. This group was heterogeneous in terms of anti-HLA antibody titers and their ability to fix complement. After dilution, 15 out of 18 patients (83.3%) showed a reduction of positive bead counts whereas 4 patients showed a prozone effect and complement fixation was demonstrated. The high dilution of sera and ascertaining the complement fixation allow the accurate definition of risk anti-HLA antibody profiles in highly sensitized patients, as demonstrated in 5 of the sensitized patients who were transplanted.

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