HLA antibody screening strategy in patients awaiting kidney transplantation
The reactivity between donor's Human Leukocyte Antigen (HLA) and recipient's anti-HLA antibody in pretransplantation assessment is one of the critical factors to determining successful outcome of renal transplantation. Objective: The aim of present study was to compare different techniques of HLA antibody detection in patients waiting for a kidney transplant. Methods. Two techniques of HLA antibody screening were compared: the complement-dependent citotoxicity (CDC) test and enzyme-linked
... sorbent assay (ELISA). The study included 606 sera samples of 236 patients waiting for a first kidney transplantation. Results. Of 606 tested sera, 469 (77.39%) were negative by both methods. Of the 137 (22.6%) positive sera, 73 (12.04%) were positive only by ELISA method, 48 (7.92%) by both CDC and ELISA methods and 16 (2.64%) only by CDC method. There was a significant (p<0.05) correlation between optical densities obtained by ELISA and the PRA determined by cytotoxicity testing. Conclusion. Fast and precise characterisation of antibodies in patients before transplantation can be performed by both methods, CDC and ELISA, as complementary techniques. ELISA method is more sensitive and effective than CDC, enabling significant reduction of the CDC workload of the laboratory, but can be used only as adjunct to serum screening by citotoxic testing.