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Caso único de detección de anticuerpos pan-HLA-A falsos positivos en el ensayo de perlas de antígeno único de

Merschman Jarret¹, Barnes Rachel¹, Burmeister Lydia¹

¹Division of Transfusion Medicine, Mayo Clinic, 200 1st street SW, Rochester MN 55905, USA.

Human immunology

|February 11, 2026

Resumen

Este estudio reporta el primer caso de reactividad de anticuerpos pan-HLA-A falsamente positivo detectado por un ensayo específico de perlas de un solo antígeno después de un trasplante de hígado y riñón. Reconocer tales artefactos es crucial para una evaluación precisa del riesgo de trasplante.

Área de la Ciencia:

Inmunología de trasplante de inmunología.
Inmunogenética La inmunogenética.
Desarrollo de ensayos de diagnóstico.

Sus antecedentes:

La detección precisa de anticuerpos contra el antígeno leucocitario humano (HLA) es fundamental para controlar el riesgo inmunológico del trasplante.
Los ensayos de fase sólida (SPA), incluidos los ensayos de perla de antígeno único (SAB), ofrecen una alta sensibilidad, pero pueden producir resultados falsos positivos.
Anteriormente, se había documentado una reactividad pan-HLA-C/DR falsamente positiva, pero no la reactividad pan-HLA-A.

Objetivo del estudio:

Informar del primer caso documentado de reactividad pan-HLA-A falsamente positiva.
Para investigar la causa de este artefacto en un paciente trasplantado.
Para enfatizar la importancia de reconocer artefactos específicos del ensayo en las pruebas de anticuerpos HLA.

Principales métodos:

Un paciente con trasplante combinado de hígado y riñón desarrolló reactividad pan-HLA-A en un ensayo LABScreenTM SAB basado en Luminex.
Se realizaron pruebas de repetición, tratamiento Presorb TM, plataformas SAB alternativas (LIFECODES® LSATM), cuentas mixtas LABScreen TM y coincidencias cruzadas de flujo de sustitución.
Las pruebas con cuentas tratadas con ácido se utilizaron para excluir anticuerpos contra el HLA desnaturalizado.

Principales resultados:

La reactividad pan-HLA-A fue consistentemente detectada por el ensayo SAB inicial un año después del trasplante.
Los métodos y plataformas de prueba alternativos no confirmaron la presencia de anticuerpos HLA-A.
Las coincidencias cruzadas del flujo de sustitución fueron negativas, lo que indica la ausencia de anticuerpos reactivos a las células.

Conclusiones:

Este caso representa el primer informe de reactividad pan-HLA-A falsamente positiva específica de un solo producto comercial SAB.
Tales artefactos dependientes del ensayo pueden conducir a una mala interpretación de las especificidades de los anticuerpos.
La concienciación y las pruebas de confirmación apropiadas son esenciales para evitar la clasificación errónea y garantizar la seguridad del paciente en el trasplante.

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