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Clinical utility of serial serum dilutions for HLA antibody interpretation
Luminex single antigen bead (SAB) testing has increased the sensitivity and specificity of accurately identifying HLA antibodies, in support of all organ transplantation. However, as described in manufacturers' recommendation, the output of the assay, using mean fluorescence intensity (MFI) uni...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Blackwell Publishing Ltd
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9804468/ https://www.ncbi.nlm.nih.gov/pubmed/35986896 http://dx.doi.org/10.1111/tan.14781 |
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author | Tambur, Anat R. Schinstock, Carrie |
author_facet | Tambur, Anat R. Schinstock, Carrie |
author_sort | Tambur, Anat R. |
collection | PubMed |
description | Luminex single antigen bead (SAB) testing has increased the sensitivity and specificity of accurately identifying HLA antibodies, in support of all organ transplantation. However, as described in manufacturers' recommendation, the output of the assay, using mean fluorescence intensity (MFI) units, is only semi‐quantitative. Therefore, the ability to use MFI values to compare between different assays, to accurately guide clinical practice, or be used as an endpoint measure in clinical trials, is limited. To improve potential quantification, one must circumvent inherent limitations of SAB assays such as interference and saturation phenomena. In this review, we discuss how measurement of pre‐transplant serum dilutions can be used to determine unacceptable antigens for wait‐listing, determine the likelihood for successful HLA antibody reduction with desensitization, and compare degree of HLA (in)compatibility among various living donors. We also discuss how serum dilutions are optimal for measuring and comparing the efficacy of antibody depletion therapies for desensitization or antibody mediated rejection treatment post‐transplant. Historically, one of the main criticisms for the use of serum dilutions and titer has been the potential labor and cost associated with additional testing. Here, we show how only one or two dilutions can add major value in most circumstances. In summary, the practical use of serum dilutions and titer determination are important methods that can be used before and after transplantation of all organs to quantify antibody accurately and reliably in routine practice and in clinical trials. |
format | Online Article Text |
id | pubmed-9804468 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Blackwell Publishing Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-98044682023-01-03 Clinical utility of serial serum dilutions for HLA antibody interpretation Tambur, Anat R. Schinstock, Carrie HLA Review Article Luminex single antigen bead (SAB) testing has increased the sensitivity and specificity of accurately identifying HLA antibodies, in support of all organ transplantation. However, as described in manufacturers' recommendation, the output of the assay, using mean fluorescence intensity (MFI) units, is only semi‐quantitative. Therefore, the ability to use MFI values to compare between different assays, to accurately guide clinical practice, or be used as an endpoint measure in clinical trials, is limited. To improve potential quantification, one must circumvent inherent limitations of SAB assays such as interference and saturation phenomena. In this review, we discuss how measurement of pre‐transplant serum dilutions can be used to determine unacceptable antigens for wait‐listing, determine the likelihood for successful HLA antibody reduction with desensitization, and compare degree of HLA (in)compatibility among various living donors. We also discuss how serum dilutions are optimal for measuring and comparing the efficacy of antibody depletion therapies for desensitization or antibody mediated rejection treatment post‐transplant. Historically, one of the main criticisms for the use of serum dilutions and titer has been the potential labor and cost associated with additional testing. Here, we show how only one or two dilutions can add major value in most circumstances. In summary, the practical use of serum dilutions and titer determination are important methods that can be used before and after transplantation of all organs to quantify antibody accurately and reliably in routine practice and in clinical trials. Blackwell Publishing Ltd 2022-08-29 2022-11 /pmc/articles/PMC9804468/ /pubmed/35986896 http://dx.doi.org/10.1111/tan.14781 Text en © 2022 The Authors. HLA: Immune Response Genetics published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Review Article Tambur, Anat R. Schinstock, Carrie Clinical utility of serial serum dilutions for HLA antibody interpretation |
title | Clinical utility of serial serum dilutions for HLA antibody interpretation |
title_full | Clinical utility of serial serum dilutions for HLA antibody interpretation |
title_fullStr | Clinical utility of serial serum dilutions for HLA antibody interpretation |
title_full_unstemmed | Clinical utility of serial serum dilutions for HLA antibody interpretation |
title_short | Clinical utility of serial serum dilutions for HLA antibody interpretation |
title_sort | clinical utility of serial serum dilutions for hla antibody interpretation |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9804468/ https://www.ncbi.nlm.nih.gov/pubmed/35986896 http://dx.doi.org/10.1111/tan.14781 |
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