Hwang Hyeon Seok, Hyoung Bok Jin, Lee So Young, Jeon Youn Joo, Yoon Hye Eun, Kim Jin Young, Choi Bum Soon, Oh Eun Jee, Kim Yong Soo, Bang Byung Kee, Yang Chul Woo
Departments of Internal Medicine, Kangnam St. Mary's Hospital, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, Seoul, South Korea.
Nephron Clin Pract. 2009;111(4):c260-4. doi: 10.1159/000209153. Epub 2009 Mar 17.
BACKGROUND/AIMS: The antibody monitoring system (AMS) is a recently developed enzyme-linked immunosorbent assay (ELISA) crossmatch assay to detect donor-specific anti-HLA immunoglobulin G antibodies (DS-HLA Abs). This study was conducted to compare the AMS with the flow cytometric crossmatch (FCXM) test in renal transplant recipients with high panel-reactive antibody (PRA).
Thirty-two sera were obtained from 10 patients with panel reactivity above 50%. When anti-HLA Ab was detected by ELISA PRA and the matched donor had the corresponding HLA antigen, it was considered to indicate DS-HLA Ab. The results of the AMS assay and FCXM were compared with the DS-HLA Abs.
Twenty-three (71.9%) sera were positive for DS-HLA Abs by ELISA PRA. The AMS assay showed that the number of compatible sera with DS-HLA Abs was 27 (84.4%), and it was significantly concordant (kappa = 0.649, p < 0.0001). For FCXM, the number of compatible sera with DS-HLA Abs was 26 (81.3%), and it was also significantly concordant (kappa = 0.614, p < 0.0001). There was a significant degree of concordance between the AMS assay and FCXM in detection of DS-HLA Abs (kappa = 0.452, p = 0.010).
The AMS assay is comparable to FCXM in detecting DS-HLA Abs in high PRA recipients.
背景/目的：抗体监测系统（AMS）是一种最近开发的酶联免疫吸附测定（ELISA）交叉配型测定法，用于检测供体特异性抗人白细胞抗原免疫球蛋白G抗体（DS-HLA Abs）。本研究旨在比较AMS与流式细胞术交叉配型（FCXM）试验在高群体反应性抗体（PRA）的肾移植受者中的应用。
从10名群体反应性高于50%的患者中获取32份血清。当通过ELISA PRA检测到抗HLA抗体且匹配的供体具有相应的HLA抗原时，认为提示DS-HLA抗体。将AMS测定结果和FCXM结果与DS-HLA抗体进行比较。
通过ELISA PRA检测，23份（71.9%）血清DS-HLA抗体呈阳性。AMS测定显示，与DS-HLA抗体相容的血清数量为27份（84.4%），且具有显著一致性（kappa = 0.649，p < 0.0001）。对于FCXM，与DS-HLA抗体相容的血清数量为26份（81.3%），也具有显著一致性（kappa = 0.614，p < 0.0001）。在检测DS-HLA抗体方面，AMS测定与FCXM之间存在显著程度的一致性（kappa = 0.452，p = 0.010）。
在检测高PRA受者的DS-HLA抗体方面，AMS测定与FCXM相当。
