잠시만 기다려 주세요. 로딩중입니다.

Causes of Positive Pretransplant Crossmatches in the Absence of Donor-Specific Anti-Human Leukocyte Antigen Antibodies: A Single-Center Experience

Annals of Laboratory Medicine 2021년 41권 4호 p.429 ~ 435
강현혜, 유재은, 이상윤, 오은지,
소속 상세정보
강현혜 ( Kang Hyun-Hye ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Laboratory Medicine
유재은 ( Yoo Jae-Eun ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Laboratory Medicine
이상윤 ( Lee Sang-Yoon ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Laboratory Medicine
오은지 ( Oh Eun-Jee ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Laboratory Medicine

Abstract


Pretransplant crossmatch (XM) testing is widely used for detecting preformed donor-specific antibodies (DSAs) against human leukocyte antigen (HLA). However, in some cases, there is a positive XM result in the absence of HLA-DSAs, the cause of which was rarely identified. We reviewed the causes of sequential positive XM results at a single center and analyzed the presence of non-HLA antibodies in patients with an unexplained positive pretransplant XM result. Among 251 patients with T-cell/B-cell complement-dependent cytotoxicity (CDC) or flow cytometric crossmatch (FCXM) positivity, HLA-DSAs were confirmed in 88 (35.1%) by a single antigen bead (SAB) assay, 150 (59.8%) used rituximab (anti-CD20), and 13 (5.2%) had neither HLA-DSAs nor a desensitization history. Anti-angiotensin II type 1 receptor IgG and 33 non-HLA antibodies were tested in the 13 patients with an unexplained positive pretransplant XM result, and more than one non-HLA antibody were revealed in all these patients; 11 patients had non-HLA antibodies reported to be associated with graft rejection, and two patients experienced rejection episode after kidney transplantation. Our study suggests considering non-HLA antibodies testing when a CDC or FCXM test is positive without a definite cause. Assessing non-HLA antibodies might be useful for interpreting XM results and evaluating immunologic risk in transplant recipients.

키워드

Complement-dependent cytotoxicity; Flow cytometric crossmatch; Donor-specific antibodies against human leukocyte antigen; non-HLA antibodies; Transplantation

원문 및 링크아웃 정보

등재저널 정보