Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland 21287-6667, USA.
Transfusion. 2010 Mar;50(3):631-4. doi: 10.1111/j.1537-2995.2009.02478.x. Epub 2009 Nov 9.
We have monitored ABO antibody titers in 53 ABO-incompatible kidney transplants (INKTs) using a time-consuming, conventional test tube (CTT) method that included a 30-minute room temperature (RT) phase, followed by incubation for 30 minutes at 37 degrees C and conversion to the anti-human globulin (AHG) phase. Our studies have indicated that AHG ABO antibody titers are critical for clinical management, but RT titers do not supplement clinical decision making. Therefore, we assessed AHG titers by two methods: 1) a revised test tube (TT) method without RT and 2) an anti-immunoglobulin G (IgG) gel microcolumn (IgG gel) method with a goal of streamlining ABO antibody titrations.
Fifty frozen samples from our INKT collection with anti-A and/or anti-B AHG titers of 2 to 512 were titrated by revised TT method with 30 minutes at 37 degrees C and conversion to AHG and by IgG gel method with 15 minutes at 37 degrees C and centrifugation.
The titers using the revised TT and IgG gel methods had 64 and 52% concordance, respectively, with CTT AHG titers. Neither the revised TT AHG titers nor the IgG gel titers varied by more than one standard dilution from the CTT AHG titers, which is within acceptable limits for titration techniques.
The revised TT and IgG gel titers are comparable to the CTT AHG titers. The IgG gel method offers the best titer turnaround time, eliminating 45 minutes of incubation time alone. Implementation of this technique would benefit ABO INKT patients by providing titer results in a more timely manner.
我们使用一种耗时的传统试管（CTT）方法监测了 53 例 ABO 不相容肾移植（INKT）中的 ABO 抗体效价，该方法包括 30 分钟室温（RT）阶段，然后在 37°C 孵育 30 分钟，并转化为抗人球蛋白（AHG）阶段。我们的研究表明，AHG ABO 抗体效价对临床管理至关重要，但 RT 效价不能补充临床决策。因此，我们通过两种方法评估 AHG 效价：1）不包括 RT 的修订试管（TT）方法，2）抗免疫球蛋白 G（IgG）凝胶微柱（IgG 凝胶）方法，目的是简化 ABO 抗体滴定。
我们的 INKT 收藏中 50 个冷冻样本的抗 A 和/或抗 B AHG 效价为 2 至 512，通过修订的 TT 方法在 37°C 下孵育 30 分钟并转化为 AHG，以及 IgG 凝胶方法在 37°C 下孵育 15 分钟和离心。
修订 TT 和 IgG 凝胶方法的效价与 CTT AHG 效价分别具有 64%和 52%的一致性。修订 TT AHG 效价和 IgG 凝胶效价都没有比 CTT AHG 效价多一个标准稀释度变化，这在滴定技术的可接受范围内。
修订 TT 和 IgG 凝胶效价与 CTT AHG 效价相当。IgG 凝胶法提供了最佳的效价周转时间，仅消除了 45 分钟的孵育时间。实施这项技术将通过更及时地提供效价结果使 ABO INKT 患者受益。
