Journal List > J Korean Soc Transplant > v.25(3) > 1034342

J Korean Soc Transplant. 2011 Sep;25(3):169-175. Korean.
Published online September 30, 2011.  https://doi.org/10.4285/jkstn.2011.25.3.169
Copyright © 2011 The Korean Society for Transplantation
Predictive Value of Donor Specific Antibody Measured by Luminex Single Antigen Assay for Antibody Mediated Rejection after Kidney Transplantation
Dong Jin Joo, M.D.,1,2 Kyu Ha Huh, M.D.,1,2 Yu Seun Kim, M.D.,1,2 Seok Jun Yoon, M.D.,1 Hae-Jin Kim, B.S.,2 Seung-sook Sohn, B.S.,2 Hyun Jung Kim, R.N.,2 Soon Il Kim, M.D.,1,2 Hyon-Suk Kim, M.D.,3 and Myoung Soo Kim, M.D.1,2
1Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
2Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea.
3Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author (Email: ysms91@yuhs.ac )
Received May 20, 2011; Accepted July 21, 2011.

Abstract

Background

Luminex panel reactive antibody (PRA) is a method that is well known for its high sensitivity and specificity. By using a single antigen assay, the presence or absence of donor specific antibody (DSA) can be determined and its strength can be quantified in terms of the mean fluorescence intensity (MFI). In this study, we analyzed the correlation between the pre-transplant PRA and DSA measured by the Luminex method and the post-transplant clinical features after kidney transplantation.

Methods

A total of 123 pre-transplant sera samples from kidney transplanted patients were tested. Luminex-PRA identification tests were performed using a Luminex fluoroanalyzer and a LifeCodes class I, II ID Kits. Single antigen assay by the Luminex method was used for detecting DSA and its MFI.

Results

The positive Luminex-PRA group included more highly-sensitized patients such as women, patients with a previously positive lymphocyte cross match test and patients who were undergoing retransplantation. There was no correlation between the acute rejection rate and positive PRA on the Luminex-PRA. However, pretransplant DSA detected by the single antigen assay was significantly associated with episodes of antibody mediated rejection (P=0.047, OR=10.2), and DSA with higher MFI values (MFI≥3,000) was associated with antibody mediated rejection (P=0.023).

Conclusions

Although pre-transplant positive PRA was not correlated with acute rejection episodes, the DSA measured by the Luminex single antigen assay seems to have a predictive value for post-transplant antibody mediated rejection.

Keywords: Histocompatibility antigen; Kidney transplantation; Rejection

Figures


Fig. 1
Graft survival rate according to pre-transplant panel reactive antibody (PRA) and donor specific antibody (DSA). Abbreviations: PRA, panel reactive antibody measured by Luminex-PRA test; DSA, donor specific antibody measured by Luminex-Single antigen PRA test.
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Fig. 2
Post-transplant change of graft function measured by estimated glomerular filtration rate (eGFR, by MDRD formula) according to the pre-transplant panel reactive antibody (PRA) and donor specific antibody (DSA) status. Abbreviations: PRA, panel reactive antibody measured by Luminex-PRA test; DSA, donor specific antibody measured by Luminex-Single antigen PRA test. *P<0.05.
Click for larger image

Tables


Table 1
Association between clinical factors related with HLA alloimmunization and panel reactive antibody (PRA) results by Luminex method
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Table 2
Association between acute rejection episodes and panel reactive antibody (PRA) results by Luminex method
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Table 3
Association between acute rejection episodes and pre-transplant donor specific antibody (DSA) status
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Table 4
Association between acute rejection episodes and strength (MFI values) of donor specific antibody which was measured by single antigen assay
Click for larger image

References
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