Interpretation of HLA single antigen bead assays

Abstract The introduction of single antigen bead (SAB) assays for detection and quantitation of HLA antibodies has improved our ability to identify and manage allosensitized transplant candidates and recipients and to improve organ allocation, and was critical to the creation of national paired kidn...

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Bibliographic Details
Published in:Transplantation reviews (Philadelphia, Pa.) Pa.), 2013-10, Vol.27 (4), p.108-111
Main Author: Ellis, Thomas M
Format: Article
Language:English
Subjects:
Animals
Antibodies - analysis
Antibodies - immunology
Graft Rejection - diagnosis
Graft Rejection - immunology
Histocompatibility Testing - methods
HLA Antigens - immunology
Humans
Kidney Transplantation
Surgery
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Summary:Abstract The introduction of single antigen bead (SAB) assays for detection and quantitation of HLA antibodies has improved our ability to identify and manage allosensitized transplant candidates and recipients and to improve organ allocation, and was critical to the creation of national paired kidney exchanges. The principal limitations of the technology have been detailed in the literature and include artifacts resulting in non-specific background, variability, lack of standardization, and interpretive challenges. Accurate interpretation of SAB assays requires consideration of a number of factors, including identification of epitope reactivity patterns, mean fluorescence intensity (MFI) values, patient history, and appreciation of individual bead and assay nuances. The MFI value provides an estimate of relative HLA antibody levels although limited by saturation and epitope distribution effects. A better understanding of SAB assays and MFI values will be necessary to ensure appropriate application of these assays clinically and a higher quality of antibody data used in support of published clinical studies.
ISSN:0955-470X
1557-9816
DOI:10.1016/j.trre.2013.07.001