Journal
TRANSPLANTATION
Volume 79, Issue 10, Pages 1459-1461Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/01.TP.0000156164.54216.DE
Keywords
anti-HLA antibodies; ELISA; flow cytometry; kidney transplantation; chronic allograft nephropathy; needle core biopsy
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The aim of this study was to assess the feasibility of detecting anti-HLA antibodies in eluates from needle core biopsies of renal transplants with chronic allograft nephropathy. Two methods of screening, the enzyme-linked immunosorbent assay (ELISA) and flow cytometry (FlowPRA) were compared. Twenty renal transplants with CAN were removed after irreversible graft failure. To assess the feasibility of detecting anti-HLA antibodies in small samples, needle core biopsies were sampled at the same place as surgical samples and at a second cortical area. Antibodies were eluted with an acid elution kit and anti-class I and class Il IgG HLA antibodies detected using ELISA and flow cytometry. Flow cytometry was found to be more sensitive than ELISA for detecting anti-HLA antibodies in eluates from renal transplants with CAN (95% vs. 75% of positive cases). Detection of anti-HLA antibodies showed good agreement between surgical samples and needle core biopsies performed at the same place for anti-class 1 (80% vs. 65%, r=0.724 P < 0.01) and anti-class H HLA antibodies (70% vs. 55%, r=0.827 P < 0.01). In addition, differences in the detection of anti-class I HLA antibodies in needle core biopsies sampled at different sites suggests that immunization to class I donor antigen could be underestimated in needle core biopsy samples. These data indicate that anti-HLA antibodies can be detected in needle core biopsies from renal transplants. Provided further evaluation is done, elution might be a complementary method to detect anti-FILA antibodies when they are bound to the transplant.
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