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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

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dc.contributor.authorSchlaf, Gerald
dc.contributor.authorMauz-Körholz, Christine
dc.contributor.authorOtt, Undine
dc.contributor.authorLeike, Steffen
dc.contributor.authorAltermann, Wolfgang
dc.date.accessioned2017-03-07T19:42:08Z
dc.date.available2017-03-07T19:42:08Z
dc.date.issued2012
dc.description.abstractAntibodies 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.es
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dc.format.extent8es
dc.identifier.citationHistology and histopathology, Vol. 27, nº 1 (2012)
dc.identifier.issn1699-5848
dc.identifier.issn0213-3911
dc.identifier.urihttp://hdl.handle.net/10201/52363
dc.languageenges
dc.publisherF. Hernández y Juan F. Madrid. Universidad de Murcia: Departamento de Biología Celular e Histologíaes
dc.rightsinfo:eu-repo/semantics/openAccesses
dc.subjectAllograftes
dc.subjectAntibodieses
dc.subject.otherCDU::6 - Ciencias aplicadas::61 - Medicinaes
dc.titleGeneral insufficiency of the classical CDC-based crossmatch to detect donor-specific anti-HLA antibodies leading to invalid results under recipients’ medical treatment or underlying diseaseses
dc.typeinfo:eu-repo/semantics/articlees
dspace.entity.typePublicationes
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Histology and histopathology Vol.27, nº 1 (2012)