Detection of antibodies to denatured Human Leucocyte Antigen molecules by Single Antigen Luminex.

Introduction The anti-HLA antibody detection has been improved in sensitivity and specificity with solid-phase antigen bead (SAB) assays based on Luminex. However, false positive results due to denatured HLA may arise after single antigen test. The aim of this study was to compare the performance of the two Luminex technology-based anti-HLA detection kits available in the market in revealing undesired anti-HLA antibody results. Methods and materials A prospective cohort was assessed for anti-HLA antibodies with single antigen A manufacturer (AM) kit and a comparison cohort with single antigen B manufacturer (BM) kit. Results A total of 11 out of 90 patients in a prospective cohort presented monospecific HLA-I antibodies with AM, and 5 out of 11 confirmed monospecific reaction with BM. Despite the confirmation of monospecific reaction with both manufacturers, 80% were assigned as denatured HLA reaction by specific crossmatch. Further comparative cohorts detected 4 out of 6 monospecific reactions with BM that were confirmed as possible denatured HLA reactions. Conclusions A positive SAB test should rule out a reaction against a denatured HLA molecule, thus avoidance of prolonged waitlist periods or misattribution of anti-HLA reactions after transplantation. This article is protected by copyright. All rights reserved.