Details

Autor(en) / Beteiligte

• Wisse, Bram W
• Kamburova, Elena G
• Joosten, Irma
• Allebes, Wil A
• van der Meer, Arnold
• Hilbrands, Luuk B
• Baas, Marije C
• Spierings, Eric
• Hack, Cornelis E
• van Reekum, Franka E
• van Zuilen, Arjan D
• Verhaar, Marianne C
• Bots, Michiel L
• Drop, Adriaan C A D
• Plaisier, Loes
• Seelen, Marc A J
• Stephan Sanders, Jan
• Hepkema, Bouke G
• Lambeck, Annechien J A
• Bungener, Laura B
• Roozendaal, Caroline
• Tilanus, Marcel G J
• Voorter, Christina E
• Wieten, Lotte
• van Duijnhoven, Elly M
• Gelens, Mariëlle A C J
• Christiaans, Maarten H L
• van Ittersum, Frans J
• Nurmohamed, Shaikh A
• Lardy, Neubury M
• Swelsen, Wendy
• van der Pant, Karlijn A M I
• van der Weerd, Neelke C
• Ten Berge, Ineke J M
• Bemelman, Frederike J
• Hoitsma, Andries J
• van der Boog, Paul J M
• de Fijter, Johan W
• Betjes, Michiel G H
• Heidt, Sebastiaan
• Roelen, Dave L
• Claas, Frans H
• Otten, Henny G

Titel

Toward a Sensible Single-antigen Bead Cutoff Based on Kidney Graft Survival

Ist Teil von

• Transplantation, 2019-04, Vol.103 (4), p.789-797

Ort / Verlag

United States

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• There is no consensus in the literature on the interpretation of single-antigen bead positive for a specific HLA antibody. To inform the debate, we studied the relationship between various single-antigen bead positivity algorithms and the impact of resulting donor-specific HLA antibody (DSA) positivity on long-term kidney graft survival in 3237 deceased-donor transplants. First, we showed that the interassay variability can be greatly reduced when working with signal-to-background ratios instead of absolute median fluorescence intensities (MFIs). Next, we determined pretransplant DSA using various MFI cutoffs, signal-to-background ratios, and combinations thereof. The impact of the various cutoffs was studied by comparing the graft survival between the DSA-positive and DSA-negative groups. We did not observe a strong impact of various cutoff levels on 10-year graft survival. A stronger relationship between the cutoff level and 1-year graft survival for DSA-positive transplants was found when using signal-to-background ratios, most pronounced for the bead of the same HLA locus with lowest MFI taken as background. With respect to pretransplant risk stratification, we propose a signal-to-background ratio-6 (using the bead of the same HLA-locus with lowest MFI as background) cutoff of 15 combined with an MFI cutoff of 500, resulting in 8% and 21% lower 1- and 10-year graft survivals, respectively, for 8% DSA-positive transplants.