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Assignment of C1q-binding HLA antibodies as unacceptable HLA antigens avoids positive CDC-crossmatches prior to transplantation of deceased donor organs

Standard

Assignment of C1q-binding HLA antibodies as unacceptable HLA antigens avoids positive CDC-crossmatches prior to transplantation of deceased donor organs. / Juhl, David; Marget, Matthias; Hallensleben, Michael; Görg, Siegfried; Ziemann, Malte.

In: TRANSPL IMMUNOL, Vol. 41, 03.2017, p. 17-21.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Juhl, D, Marget, M, Hallensleben, M, Görg, S & Ziemann, M 2017, 'Assignment of C1q-binding HLA antibodies as unacceptable HLA antigens avoids positive CDC-crossmatches prior to transplantation of deceased donor organs', TRANSPL IMMUNOL, vol. 41, pp. 17-21. https://doi.org/10.1016/j.trim.2017.01.001

APA

Juhl, D., Marget, M., Hallensleben, M., Görg, S., & Ziemann, M. (2017). Assignment of C1q-binding HLA antibodies as unacceptable HLA antigens avoids positive CDC-crossmatches prior to transplantation of deceased donor organs. TRANSPL IMMUNOL, 41, 17-21. https://doi.org/10.1016/j.trim.2017.01.001

Vancouver

Juhl D, Marget M, Hallensleben M, Görg S, Ziemann M. Assignment of C1q-binding HLA antibodies as unacceptable HLA antigens avoids positive CDC-crossmatches prior to transplantation of deceased donor organs. TRANSPL IMMUNOL. 2017 Mar;41:17-21. https://doi.org/10.1016/j.trim.2017.01.001

Bibtex

@article{031d0c40fa144f59bb48f5e951be411c,
title = "Assignment of C1q-binding HLA antibodies as unacceptable HLA antigens avoids positive CDC-crossmatches prior to transplantation of deceased donor organs",
abstract = "Soon, a virtual crossmatch shall replace the complement-dependent cytotoxicity (CDC) allocation crossmatch in the Eurotransplant region. To prevent positive CDC-crossmatches in the recipient centre, careful definition of unacceptable antigens is necessary. For highly sensitized patients, this is difficult by CDC alone. Assignment of all antibodies detected by sensitive assays, however, could prevent organ allocation. To assess the usefulness of the Luminex C1q-assay to prevent positive CDC-crossmatches, all CDC-crossmatches performed prior to deceased kidney transplantation in a 16-month-period were reviewed. Sera causing positive crossmatches were investigated by the C1q-assay. 31 out of 1432 crossmatches (2.2%) were positive. Sera involved in 26 positive crossmatches were available. C1q-binding donor-specific antibodies were detected in 19 sera (73.1%). The other sera were from recipients without any HLA antibodies detectable by CDC or common solid phase assays. Three patients had known Non-HLA antibodies causing positive CDC-results. Four crossmatches were only weak positive. Therefore, avoidance of donors with HLA antigens against whom C1q-binding antibodies were detected would have prevented all positive crossmatches due to HLA antibodies. Provided that all HLA specificities against which antibodies are detected by the Luminex C1q-assay are considered as unacceptable antigens, CDC-crossmatches prior to transplantation might safely be omitted in many patients. They should be maintained in highly immunized patients, however, for whom assignment of all C1q-positive antibodies as unacceptable antigens could lead to a significant delay or even prevention of transplantation.",
keywords = "Complement C1q, Female, HLA Antigens, Histocompatibility Testing, Humans, Isoantibodies, Male, Organ Transplantation, Tissue Donors, Journal Article",
author = "David Juhl and Matthias Marget and Michael Hallensleben and Siegfried G{\"o}rg and Malte Ziemann",
note = "Copyright {\textcopyright} 2017 Elsevier B.V. All rights reserved.",
year = "2017",
month = mar,
doi = "10.1016/j.trim.2017.01.001",
language = "English",
volume = "41",
pages = "17--21",
journal = "TRANSPL IMMUNOL",
issn = "0966-3274",
publisher = "Elsevier",

}

RIS

TY - JOUR

T1 - Assignment of C1q-binding HLA antibodies as unacceptable HLA antigens avoids positive CDC-crossmatches prior to transplantation of deceased donor organs

AU - Juhl, David

AU - Marget, Matthias

AU - Hallensleben, Michael

AU - Görg, Siegfried

AU - Ziemann, Malte

N1 - Copyright © 2017 Elsevier B.V. All rights reserved.

PY - 2017/3

Y1 - 2017/3

N2 - Soon, a virtual crossmatch shall replace the complement-dependent cytotoxicity (CDC) allocation crossmatch in the Eurotransplant region. To prevent positive CDC-crossmatches in the recipient centre, careful definition of unacceptable antigens is necessary. For highly sensitized patients, this is difficult by CDC alone. Assignment of all antibodies detected by sensitive assays, however, could prevent organ allocation. To assess the usefulness of the Luminex C1q-assay to prevent positive CDC-crossmatches, all CDC-crossmatches performed prior to deceased kidney transplantation in a 16-month-period were reviewed. Sera causing positive crossmatches were investigated by the C1q-assay. 31 out of 1432 crossmatches (2.2%) were positive. Sera involved in 26 positive crossmatches were available. C1q-binding donor-specific antibodies were detected in 19 sera (73.1%). The other sera were from recipients without any HLA antibodies detectable by CDC or common solid phase assays. Three patients had known Non-HLA antibodies causing positive CDC-results. Four crossmatches were only weak positive. Therefore, avoidance of donors with HLA antigens against whom C1q-binding antibodies were detected would have prevented all positive crossmatches due to HLA antibodies. Provided that all HLA specificities against which antibodies are detected by the Luminex C1q-assay are considered as unacceptable antigens, CDC-crossmatches prior to transplantation might safely be omitted in many patients. They should be maintained in highly immunized patients, however, for whom assignment of all C1q-positive antibodies as unacceptable antigens could lead to a significant delay or even prevention of transplantation.

AB - Soon, a virtual crossmatch shall replace the complement-dependent cytotoxicity (CDC) allocation crossmatch in the Eurotransplant region. To prevent positive CDC-crossmatches in the recipient centre, careful definition of unacceptable antigens is necessary. For highly sensitized patients, this is difficult by CDC alone. Assignment of all antibodies detected by sensitive assays, however, could prevent organ allocation. To assess the usefulness of the Luminex C1q-assay to prevent positive CDC-crossmatches, all CDC-crossmatches performed prior to deceased kidney transplantation in a 16-month-period were reviewed. Sera causing positive crossmatches were investigated by the C1q-assay. 31 out of 1432 crossmatches (2.2%) were positive. Sera involved in 26 positive crossmatches were available. C1q-binding donor-specific antibodies were detected in 19 sera (73.1%). The other sera were from recipients without any HLA antibodies detectable by CDC or common solid phase assays. Three patients had known Non-HLA antibodies causing positive CDC-results. Four crossmatches were only weak positive. Therefore, avoidance of donors with HLA antigens against whom C1q-binding antibodies were detected would have prevented all positive crossmatches due to HLA antibodies. Provided that all HLA specificities against which antibodies are detected by the Luminex C1q-assay are considered as unacceptable antigens, CDC-crossmatches prior to transplantation might safely be omitted in many patients. They should be maintained in highly immunized patients, however, for whom assignment of all C1q-positive antibodies as unacceptable antigens could lead to a significant delay or even prevention of transplantation.

KW - Complement C1q

KW - Female

KW - HLA Antigens

KW - Histocompatibility Testing

KW - Humans

KW - Isoantibodies

KW - Male

KW - Organ Transplantation

KW - Tissue Donors

KW - Journal Article

U2 - 10.1016/j.trim.2017.01.001

DO - 10.1016/j.trim.2017.01.001

M3 - SCORING: Journal article

C2 - 28088367

VL - 41

SP - 17

EP - 21

JO - TRANSPL IMMUNOL

JF - TRANSPL IMMUNOL

SN - 0966-3274

ER -