Original articles

Luminex-based virtual crossmatching for renal transplantation in South Africa

Catherine M Worsley, Elizabeth S Mayne, Melinda S Suchard

Abstract


Background. Current practice in the Johannesburg renal transplantation programme is to perform a transplant when the patient’s complement-dependent cytotoxicity and flow cytometric crossmatches are negative. However, even in patients with negative crossmatches early graft rejections have occurred. We retrospectively evaluated the use of Luminex anti-human leukocyte antigen (HLA) antibody detection technology, often termed ‘virtual crossmatching’, compared with the flow cytometric crossmatch, for predicting graft outcome in renal transplant patients.
Methods. Sixty-four recipients were crossmatched against multiple donors during their routine work-up for transplant (111 crossmatches); 17 of these patients received transplants during the study period. Anti-HLA antibody detection was performed using Luminex technology and the results were compared with the flow cytometric crossmatch results and with short-term graft success.
Results. Compared with flow cytometric crossmatch results, the sensitivity and specificity of Luminex virtual crossmatching was 85.7% and 90.7% for the T-cell crossmatch and 100% and 87.2% for the B-cell crossmatch. Both the sensitivity and specificity of Luminex for predicting short-term graft success were 100%.
Conclusions. Strong evidence is provided that single-antigen assays provide improved sensitivity to detect clinically relevant anti-HLA antibodies and can reliably be used to predict short-term graft success. We recommend incorporation of single-antigen Luminex methodology into the routine work-up algorithm of renal transplant recipients in South Africa.

Authors' affiliations

Catherine M Worsley, National Health Laboratory Services and University of the Witwatersrand

Elizabeth S Mayne, National Health Laboratory Services and University of the Witwatersrand

Melinda S Suchard, National Health Laboratory Services and University of the Witwatersrand

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Keywords

antibody-mediated rejection; flow cytometric crossmatch; donor-specific antibodies; HLA; Luminex; renal transplantation

Cite this article

South African Medical Journal 2012;102(1):40.

Article History

Date submitted: 2011-05-25
Date published: 2011-12-14

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