Moszkowska Grażyna, Zielińska Hanna, Zieliński Maciej, Dukat-Mazurek Anna, Dębska-Ślizień Alicja, Rutkowski Bolesław, Lewandowska Dorota, Danielewicz Roman, Trzonkowski Piotr
Department of Clinical Immunology and Transplantology, Medical University of Gdańsk, Dębinki 7, 80-210 Gdańsk, Poland.
Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdańsk, Dębinki 7, 80-210 Gdańsk, Poland.
Hum Immunol. 2014 Jul;75(7):650-5. doi: 10.1016/j.humimm.2014.04.012. Epub 2014 Apr 24.
Pretransplant identification of allosensitized patients is possible thanks to new technologies, which allow for accurate detection of clinically relevant alloantibodies. Implementation of these methods in the screening of patients awaiting transplantation increased their chance for successful donor-recipient matching. Here, 1460 patients reported to the Polish National Waiting List were screened with the Luminex Screen (LS) solid phase test for anti-HLA antibodies. The patients with detected anti-HLA antibodies were assayed with the Luminex Single Antigen (LSA) tests in order to establish defined antigen specificity of the alloantibodies. The results were compared with data on the immunization assessed with the routine complement-dependent-cytotoxicity panel-reactive-antibody assay (PRA CDC). The study showed significantly higher sensitivity of the LS method when compared with PRA CDC. It has been shown that LSA test is a useful technique identifying the specificities of alloantibodies. In particular, LSA allowed to assess donor specific antibodies (DSA) to previous mismatches (MM) and to determine acceptable HLA mismatches of the potential donors. The introduction of solid phase tests in routine pretransplant diagnostics allowed for faster and more accurate assessment of the immunological risk of the recipients and optimal donor-recipient matching. Hence, the presented algorithm of solid phase assays has become a new standard for the identification of allosensitized patients awaiting kidney transplantation in Poland.
借助新技术，移植前对致敏患者进行识别成为可能，这些技术能够准确检测出临床相关的同种抗体。在等待移植患者的筛查中应用这些方法，增加了供受者成功匹配的机会。在此，对向波兰国家等待名单报告的1460例患者进行了Luminex Screen（LS）固相检测抗HLA抗体。对检测出抗HLA抗体的患者进行Luminex单抗原（LSA）检测，以确定同种抗体的明确抗原特异性。将结果与通过常规补体依赖细胞毒性法检测的群体反应性抗体（PRA CDC）评估的免疫数据进行比较。研究表明，与PRA CDC相比，LS方法的敏感性显著更高。已证明LSA检测是一种识别同种抗体特异性的有用技术。特别是，LSA能够评估针对既往错配（MM）的供者特异性抗体（DSA），并确定潜在供者可接受的HLA错配情况。在常规移植前诊断中引入固相检测，能够更快、更准确地评估受者的免疫风险，并实现最佳的供受者匹配。因此，所提出的固相检测算法已成为波兰等待肾移植的致敏患者识别的新标准。
