Bryan Christopher F, McDonald Scott B, Baier Karen A, Luger Alan M, Aeder Mark I, Murillo Daniel, Muruve Nicolas A, Nelson Paul W, Shield Charles F, Warady Bradley A
Midwest Transplant Network, Westwood, KS 66205, USA.
Clin Transplant. 2002;16 Suppl 7:15-23. doi: 10.1034/j.1399-0012.16.s7.2.x.
HLA Class I antibody screening can be performed by flow cytometry using a mixture of 30 distinct bead populations each coated with the Class I antigen phenotype derived from different cell lines. In this study we compared the efficacy of Class I antibody screens done by flow cytometry beads with the antihuman globulin (AHG) method for patients awaiting cadaveric renal retransplantation. Class I panel reactive antibody (PRA) screening by flow cytometric beads of 21 regraft serum samples that had all been found to be negative by AHG DTT Class I PRA, revealed that 57.1% (12 of 21) had a flow Class I PRA of > or = 10%. Furthermore, when five regraft sera with an intermediate PRA were screened (mean AHG DTT PRA = 33.2 +/- 13%) the mean flow Class I PRA almost doubled (mean flow PRA = 72.4 +/- 10.2%) (p < 0.01). When active UNOS waiting list regraft candidates, after several months of screening the Class I PRA by flow beads, were divided into the three PRA categories based on their peak flow Class I PRA value (0-20%, 21-79% and > or = 80%), the incidence of a positive flow cross-match was 0%, 72% and 85% and the incidence of retransplantation was 60%, 22% and 10%, in each of these groups, respectively. These data provided our histocompatibility laboratory with the rationale to stop performing the AHG PRA and perform only the flow Class I PRA method for regraft candidates.
HLA I类抗体筛查可通过流式细胞术进行，使用30种不同的微珠群体混合物，每个微珠群体都包被有源自不同细胞系的I类抗原表型。在本研究中，我们比较了流式细胞术微珠法与抗人球蛋白（AHG）法对等待尸体肾再移植患者进行I类抗体筛查的效果。对21份再次移植血清样本进行流式细胞术微珠I类群体反应性抗体（PRA）筛查，这些样本经AHG DTT I类PRA检测均为阴性，结果显示57.1%（21份中的12份）的流式I类PRA≥10%。此外，对5份中等PRA的再次移植血清进行筛查（平均AHG DTT PRA = 33.2±13%）时，平均流式I类PRA几乎翻倍（平均流式PRA = 72.4±10.2%）（p<0.01）。当根据其峰值流式I类PRA值（0 - 20%、21 - 79%和≥80%）将活跃的器官共享联合网络（UNOS）等待名单上的再次移植候选者分为三个PRA类别时，这些组中流式交叉配型阳性的发生率分别为0%、72%和85%，再次移植的发生率分别为60%、22%和10%。这些数据为我们的组织相容性实验室提供了依据，即停止进行AHG PRA检测，仅对再次移植候选者采用流式I类PRA方法。
