Luminex-based virtual crossmatching for renal transplantation in South Africa

作者：Worsley Catherine M^*; Mayne Elizabeth S; Suchard Melinda S

来源：SAMJ South African Medical Journal, 2012, 102(1): 40-43.

Background. Current practice in the Johannesburg renal transplantation programme is to perform a transplant when the patient%26apos;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 %26apos;virtual crossmatching%26apos;, compared with the flow cytometric crossmatch, for predicting graft outcome in renal transplant patients. %26lt;br%26gt;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. %26lt;br%26gt;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%. %26lt;br%26gt;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.

• 出版日期2012-1