Organ procurement and transplantation network/united network for organ sharing histocompatibility committee collaborative study to evaluate prediction of crossmatch results in highly sensitized patients

Afzal Nikaein, Wida Cherikh, Karen Nelson, Timothy Baker, Sue Leffell, Laurine Bow, Debbie Crowe, Ketra Connick, Mary Ann Head, Malek Kamoun, Pam Kimball, Ellen Klohe, Harriet Noreen, Lorita Rebellato, Tom Sell, Karen Sullivan, Geoffrey Land

Research output: Contribution to journalArticle

Abstract

BACKGROUND.: The requirement for a prospective crossmatch limits some organ allocation to local areas. The delay necessitated by the crossmatch restricts the distance across which offers can be made without unduly increasing the ischemia time. A collaborative study involving 14 transplant centers was undertaken by the Organ Procurement and Transplantation Network/United Network for Organ Sharing (OPTN/UNOS) Histocompatibility Committee to evaluate the accuracy with which the detection of unacceptable human leukocyte antigen (HLA) antigens by most advanced solid phase immunoassays can predict crossmatch results. In addition, using actual patients' unacceptable HLA antigens, the number of compatible donors that would have been available from the OPTN deceased kidney donors during 2002 to 2004 were investigated. METHODS.: Panel reactive antibodies were performed by conventional or solid phase assays, and crossmatches were performed by cytotoxicity or flow cytometry. Analyses were stratified for T and B cell and by method of identifying unacceptable HLA antigens and crossmatch techniques. RESULTS.: Combination of solid phase immunoassays and flow cytometry crossmatches resulted in a higher prediction rates of positive T cell (86.1%-93.5%) and B-cell crossmatches (91%-97.8%). Prediction of negative crossmatches based on different combination of panel reactive antibodies and crossmatch techniques varied from 14.3% to 57.1%. Furthermore, numerous potential compatible donors were identified for each patient, regardless of their ethnicity, in the OPTN database, when predicted incompatible ones were excluded. CONCLUSIONS.: The above results showed that with the advent of solid phase immunoassays, HLA antibodies can now be accurately detected resulting in prediction of crossmatch outcome. This should facilitate organ allocation and prevents shipment of organs to distant incompatible recipients.

Original languageEnglish (US)
Pages (from-to)557-562
Number of pages6
JournalTransplantation
Volume87
Issue number4
DOIs
StatePublished - Feb 27 2009

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Keywords

  • HLA antibody identification
  • Prediction of crossmatch
  • Solid phase immunoassays

ASJC Scopus subject areas

  • Transplantation

Cite this

Nikaein, A., Cherikh, W., Nelson, K., Baker, T., Leffell, S., Bow, L., Crowe, D., Connick, K., Head, M. A., Kamoun, M., Kimball, P., Klohe, E., Noreen, H., Rebellato, L., Sell, T., Sullivan, K., & Land, G. (2009). Organ procurement and transplantation network/united network for organ sharing histocompatibility committee collaborative study to evaluate prediction of crossmatch results in highly sensitized patients. Transplantation, 87(4), 557-562. https://doi.org/10.1097/TP.0b013e3181943c76