在ABO-A2不相容的移植中进行多重珠子免疫试验
Anne M Halpin1, Cathi Murphey2, Bruce Motyka3
1Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.
概括
不兼容ABO-A2的脏移植可以扩大ABO-O和ABO-B受体的获取机会. 一项新的测试表明,抗AII抗体水平,而不仅仅是标位,可以提高这些救命程序的资格.
科学领域:
- 移植免疫学 移植免疫学
- 血型血清学 血型血清学
背景情况:
- ABO-A2不兼容 (ABO-A2i) 移植改善了ABO-O和ABO-B受体的获得.
- 目前的资格依赖于抗A血凝定位,这可能不会准确地反映抗体对抗A-II甘氨酸,血管内皮的关键抗原.
研究的目的:
- 评估抗A标位是否不准确地限制了具有较低抗A-II甘氨酸抗体的候选人ABO-A2i移植资格.
- 开发和验证一种用于测量ABO抗体特异性的新试验.
主要方法:
- 开发了一种单抗原珠子免疫试验,以检测ABO抗体特异性,包括抗A和抗B甘氨酸亚型.
- 使用对照血清验证了测定特异性和可重复性.
- 从ABO-B和ABO-O候选人的血清中测量了抗A-II甘氨酸抗体水平,此前对ABO-A2i移植资格进行了评估.
主要成果:
- 新的测定准确地测量了抗A和抗B甘氨酸亚型特异性抗体.
- 在141名候选人中,75名候选人因抗A定位 (>4) 而没有资格参加.
- 在不符合条件的候选人中,55% (41/75) 的抗A-II水平与符合条件的候选人相似 (标位≤4),表明标位与A-II特异性抗体不相关.
结论:
- 抗A血凝定位是ABO-A2i移植资格的不可靠指标.
- 开发的ABO抗体测定提供了对移植特异性抗AII抗体的更准确的评估.
- 这种改进的评估可能会增加ABO-B和ABO-O候选人的移植机会.
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