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Personalized Peptide Arrays for Detection of HLA Alloantibodies in Organ Transplantation
Published on: September 6, 2017
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Multiplex bead immunoassay in ABO-A2-incompatible kidney transplantation
Anne M Halpin1, Cathi Murphey2, Bruce Motyka3
1Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.
Summary
ABO-A2 incompatible kidney transplants can expand access for ABO-O and ABO-B recipients. A new assay shows anti-A-II antibody levels, not just titers, can improve eligibility for these life-saving procedures.
Area of Science:
- Transplantation immunology
- Blood group serology
Background:
- ABO-A2 incompatible (ABO-A2i) kidney transplants improve access for ABO-O and ABO-B recipients.
- Current eligibility relies on anti-A hemagglutination titers, which may not accurately reflect antibodies against A-II glycans, the key antigen on vascular endothelium.
Purpose of the Study:
- To assess if anti-A titers inaccurately limit ABO-A2i transplant eligibility for candidates with low anti-A-II glycan antibodies.
- To develop and validate a new assay for measuring ABO antibody specificities.
Main Methods:
- Developed a single-antigen bead immunoassay to detect ABO antibody specificities, including anti-A and anti-B glycan subtypes.
- Validated assay specificity and reproducibility using control sera.
- Measured anti-A-II glycan antibody levels in sera from ABO-B and ABO-O candidates previously evaluated for ABO-A2i kidney transplant eligibility.
Main Results:
- The new assay accurately measured anti-A and anti-B glycan subtype-specific antibodies.
- Among 141 candidates, 75 were ineligible based on anti-A titers (>4).
- Of the ineligible candidates, 55% (41/75) had anti-A-II levels similar to eligible candidates (titers ≤4), indicating titers do not correlate with A-II specific antibodies.
Conclusions:
- Anti-A hemagglutination titers are an unreliable measure for ABO-A2i kidney transplant eligibility.
- The developed ABO antibody assay provides a more accurate assessment of graft-specific anti-A-II antibodies.
- This improved assessment may increase transplant access for ABO-B and ABO-O candidates.
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