HLA typing in organ transplant part 13

mhc class 1 & ii

 

Regarding antibodies screening was done to avoid  hyperacute rejection, it is very important to identify recipient anti–HLA antibodies to antigen expressed on donor with blood cells. The pioneer method to detect such antibodies is complement-dependent cytotoxicity, in the mid 1990s, it has been gradually replaced by more-sensitive solid-phase immunoassays such as the enzyme-linked immunosorbent assay and the bead-based technology (ie, flow cytometry: Flow PRA and Flow Analyzer Luminex). These assays used micro particles coated with purified HLA molecules. Hence, the era of solid-phase microprticle technology for HLA antibody detection was born permitting the sensitive and specific  detection of HLA antibody. A comprehensive list of recommendations is provided covering the technical and pretransplantation and post transplantaion monitoring of HLA antibodies in solid organ transplantation must be used for the detection of pretransplantation HLA antibodies in solid organ transplant recipients and in particular the use of the single-antigen bead assay to detect antibodies to HLA loci such as Cw,DQA,DPA and DPB, which are not readily detected by other methods. The use of solid-phase immunoassays for antobody detection should be supplemented with cell based assays to examine the correlation between the two types of assays and to establish the likelihood of a positive crossmatch. There must be an awareness of the technical factors that can influence the results and their clinical interpretation when using the Luminex bead technology, such as variation in antigen density and the presence of denaturated antigen on the beads. The recommendation are intended to provide state-of-the-art guidance in the use and clinical  application of recently  developed methods for HLA antibody detection when used in conjunction with traditional methods.

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