Publication: General insufficiency of the classical CDC-based crossmatch to detect donor-specific anti-HLA antibodies leading to invalid results under recipients’ medical treatment or underlying diseases
Authors
Schlaf, Gerald ; Mauz-Körholz, Christine ; Ott, Undine ; Leike, Steffen ; Altermann, Wolfgang
item.page.secondaryauthor
item.page.director
Publisher
F. Hernández y Juan F. Madrid. Universidad de Murcia: Departamento de Biología Celular e Histología
publication.page.editor
publication.page.department
DOI
item.page.type
info:eu-repo/semantics/article
Description
Abstract
Antibodies directed against HLA antigen of a given donor represent the most prominent cause for hiper-acute and acute rejections. In order to select
recipients without donor-specific antibodies the
complement-dependent cytotoxicity (CDC-) crossmatch
as the standard procedure was established. As a
functional assay it strongly depends on the availability of
isolated donor lymphocytes and in particular on their
vitality. However, due to several diseases or
pharmacological treatment of a given recipient
unexpected “false-positive” results of the CDC-
crossmatch may arise. We here present three groups of
patients which demonstrate the limits of the
conventional crossmatch. 1) Kidney recipients before
living donations exhibited positive CDC-reactions due to
their conditioning using the therapeutical anti-CD20
mAb Rituximab (n=7), routinely used to deplete B-cells,
or the anti-CD25 mAb Basiliximab (n=2) to inhibit the
proliferation of activated T-cells. 2) Recipients suffering
from various leukaemias (n=5) exhibited “positive”
CDC-crossmatches using PBL of the donors, although
formerly these patients had never shown anti-HLA
antibodies. Instead of donor-specific allo-antibodies,
cytostatic agents such as 6-Mercaptopurine led to an
unspecific cell death. 3) Patients projected for post
mortem or living kidney donations (n=44) exhibited
“positive” CDC-crossmatch results which were not in
accordance with their former antibody status and,
partially, with high degrees of HLA-matching. These
implausible results were due to underlying auto-immune false-positive B-cell crossmatches by immune diseases, mainly of the systemic Inmune Complex Type III such a Lupus Erythematosus, mainly leading to false-psitive B- cell crossmatches by
complexes binding to Fcγ
-receptors. In all these 58 cases
the alternatively performed ELISA-based “Antibody
Monitoring System” (AMS-) crossmatch assay was not
artifically affected, suggesting that this assay may be
comprehensively established at least for the cases
described.
publication.page.subject
Citation
Histology and histopathology, Vol. 27, nº 1 (2012)
item.page.embargo
Ir a Estadísticas
Sin licencia Creative Commons.