Evaluation of screening tests for pre-transplant compatibility testing in live-related kidney transplants: Single-center report from India - A prospective observational study
Introduction: Pre-transplant compatibility testing involves the use of different methodologies (cell-based and solid phase based) for the determination of anti-human-leukocyte antigen (HLA) antibodies. Implementation of these donor-recipient methods in the screening of patients awaiting transplantat...
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Wolters Kluwer Medknow Publications
2021-01-01
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doaj-0ef805985cc04e90a407bf3273a0e7ae2021-07-07T10:50:51ZengWolters Kluwer Medknow PublicationsIndian Journal of Transplantation2212-00172212-00252021-01-011529910310.4103/ijot.ijot_76_20Evaluation of screening tests for pre-transplant compatibility testing in live-related kidney transplants: Single-center report from India - A prospective observational studyRajni ChauhanAseem Kumar TiwariChhavi RajvanshiSimmi MehraGeet AggarwalShyam Bihari BansalVijay KherIntroduction: Pre-transplant compatibility testing involves the use of different methodologies (cell-based and solid phase based) for the determination of anti-human-leukocyte antigen (HLA) antibodies. Implementation of these donor-recipient methods in the screening of patients awaiting transplantation increased their chance of successful graft and patient outcomes. Materials and Methods: A total of 1054 patients visiting tertiary care hospitals for pretransplant compatibility testing were screened with cell-based tests; complement-dependent cytotoxicity crossmatch (CDC-XM) and flow cytometric crossmatch (FC-XM). The patients positive for either or both screening tests were suspected to have anti-HLA antibodies. Luminex single-antigen bead (SAB) tests were performed in such patients to determine and identify antibody specificity and establish donor-specific antibody (DSA). Results: The study showed a significantly higher sensitivity of the FCXM (94.6%) method when compared with CDC-XM (35.7%), considering the SAB assay as the gold standard technique. The specificity of CDC-XM (100%) was slightly higher than the FC-XM (76.3%). Combination of FC-XM with CDC-XM (17 cases) was 100% sensitive and specific to identify DSA (s). The graft-survival was 94.77% using the proposed algorithm. Conclusions: The combination of CDC-XM and FC-XM, along with SAB assay, could be used as a screening algorithm as it is a useful technique in identifying the specificities of alloantibodies, assessment of DSAs. Hence, the presented algorithm can become a new standard for the identification of potential recipients awaiting kidney transplantation in India.http://www.ijtonline.in/article.asp?issn=2212-0017;year=2021;volume=15;issue=2;spage=99;epage=103;aulast=Chauhancompatibilitylive-relatedpre-transplantrenal transplantsingle-antigen bead |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Rajni Chauhan Aseem Kumar Tiwari Chhavi Rajvanshi Simmi Mehra Geet Aggarwal Shyam Bihari Bansal Vijay Kher |
spellingShingle |
Rajni Chauhan Aseem Kumar Tiwari Chhavi Rajvanshi Simmi Mehra Geet Aggarwal Shyam Bihari Bansal Vijay Kher Evaluation of screening tests for pre-transplant compatibility testing in live-related kidney transplants: Single-center report from India - A prospective observational study Indian Journal of Transplantation compatibility live-related pre-transplant renal transplant single-antigen bead |
author_facet |
Rajni Chauhan Aseem Kumar Tiwari Chhavi Rajvanshi Simmi Mehra Geet Aggarwal Shyam Bihari Bansal Vijay Kher |
author_sort |
Rajni Chauhan |
title |
Evaluation of screening tests for pre-transplant compatibility testing in live-related kidney transplants: Single-center report from India - A prospective observational study |
title_short |
Evaluation of screening tests for pre-transplant compatibility testing in live-related kidney transplants: Single-center report from India - A prospective observational study |
title_full |
Evaluation of screening tests for pre-transplant compatibility testing in live-related kidney transplants: Single-center report from India - A prospective observational study |
title_fullStr |
Evaluation of screening tests for pre-transplant compatibility testing in live-related kidney transplants: Single-center report from India - A prospective observational study |
title_full_unstemmed |
Evaluation of screening tests for pre-transplant compatibility testing in live-related kidney transplants: Single-center report from India - A prospective observational study |
title_sort |
evaluation of screening tests for pre-transplant compatibility testing in live-related kidney transplants: single-center report from india - a prospective observational study |
publisher |
Wolters Kluwer Medknow Publications |
series |
Indian Journal of Transplantation |
issn |
2212-0017 2212-0025 |
publishDate |
2021-01-01 |
description |
Introduction: Pre-transplant compatibility testing involves the use of different methodologies (cell-based and solid phase based) for the determination of anti-human-leukocyte antigen (HLA) antibodies. Implementation of these donor-recipient methods in the screening of patients awaiting transplantation increased their chance of successful graft and patient outcomes. Materials and Methods: A total of 1054 patients visiting tertiary care hospitals for pretransplant compatibility testing were screened with cell-based tests; complement-dependent cytotoxicity crossmatch (CDC-XM) and flow cytometric crossmatch (FC-XM). The patients positive for either or both screening tests were suspected to have anti-HLA antibodies. Luminex single-antigen bead (SAB) tests were performed in such patients to determine and identify antibody specificity and establish donor-specific antibody (DSA). Results: The study showed a significantly higher sensitivity of the FCXM (94.6%) method when compared with CDC-XM (35.7%), considering the SAB assay as the gold standard technique. The specificity of CDC-XM (100%) was slightly higher than the FC-XM (76.3%). Combination of FC-XM with CDC-XM (17 cases) was 100% sensitive and specific to identify DSA (s). The graft-survival was 94.77% using the proposed algorithm. Conclusions: The combination of CDC-XM and FC-XM, along with SAB assay, could be used as a screening algorithm as it is a useful technique in identifying the specificities of alloantibodies, assessment of DSAs. Hence, the presented algorithm can become a new standard for the identification of potential recipients awaiting kidney transplantation in India. |
topic |
compatibility live-related pre-transplant renal transplant single-antigen bead |
url |
http://www.ijtonline.in/article.asp?issn=2212-0017;year=2021;volume=15;issue=2;spage=99;epage=103;aulast=Chauhan |
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