1
|
Al Attas R, Alzahrani M, Al-Otaibi AS, Lopez R, Liacini A, Alzahrani S, Ajlan K, Abduladheem D, Kebasi S, Harbi H. Discrepant Antibody Testing Results: Which One to Believe? Transplant Proc 2019; 51:497-503. [PMID: 30879576 DOI: 10.1016/j.transproceed.2019.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The impact of solid-phase immunoassay for HLA antibody detection on the field of transplantation has been extremely significant by providing the most sensitive and precise method for characterization of HLA antibodies. However, despite all the benefits, technical limitations and inherent artifacts represent significant challenges, particularly with Luminex-based single-antigen bead (SAB) assay. Discordant results between antibody detection (screening assay) and identification (SAB) is not uncommon. Positive SAB assay in the context of negative screening testing is well documented and attributed to altered tertiary structure of HLA molecules exposing new epitopes or detection of naturally occurring antibodies. However, there are few reports that addressed the opposite scenario when negative SAB appeared in the context of positive screening assay. In such discrepant results, unmissed HLA antibody has to be excluded with certainty by other tests; however, with the availability of variable assays it may be difficult to choose the best combinations that clarify discrepancy without adding more confusion. Here we describe the results of correlation between 2 antibody screening solid-phase immunoassays (LABScreen Mixed using Luminex and FlowPRA Screen) on conventional flow cytometry and compare their outcomes with SAB and crossmatch results.
Collapse
Affiliation(s)
- Rabab Al Attas
- Histocompatibility and Immunogenetic Laboratory, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia.
| | - Mariam Alzahrani
- Histocompatibility and Immunogenetic Laboratory, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | - Ahmed S Al-Otaibi
- Histocompatibility and Immunogenetic Laboratory, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | - Ricardo Lopez
- Histocompatibility and Immunogenetic Laboratory, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | - Abdelhamid Liacini
- Histocompatibility and Immunogenetic Laboratory, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | - Saber Alzahrani
- Histocompatibility and Immunogenetic Laboratory, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | - Kenana Ajlan
- Histocompatibility and Immunogenetic Laboratory, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | - Dalal Abduladheem
- Histocompatibility and Immunogenetic Laboratory, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | - Shaima Kebasi
- Histocompatibility and Immunogenetic Laboratory, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | - Hassan Harbi
- Histocompatibility and Immunogenetic Laboratory, Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| |
Collapse
|
2
|
Roberts T, Tumer G, Gebel HM, Bray RA. Solid-phase assays for the detection of alloantibody against human leukocyte antigens: Panacea or Pandora? Int J Immunogenet 2014; 41:362-9. [DOI: 10.1111/iji.12138] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 05/30/2014] [Accepted: 06/12/2014] [Indexed: 12/01/2022]
Affiliation(s)
- T. Roberts
- Department of Pathology; Emory University; Atlanta GA USA
| | - G. Tumer
- Department of Pathology; Emory University; Atlanta GA USA
| | - H. M. Gebel
- Department of Pathology; Emory University; Atlanta GA USA
| | - R. A. Bray
- Department of Pathology; Emory University; Atlanta GA USA
| |
Collapse
|