Publication
Specificity and Sensitivity of Screening for Anti-HLA Antibodies in Kidney Allograft Dysfunction
| dc.contributor.author | Viana, H | |
| dc.contributor.author | Nolasco, F | |
| dc.contributor.author | Santos, MC | |
| dc.contributor.author | Carvalho, F | |
| dc.contributor.author | Galvão, MJ | |
| dc.contributor.author | Santos, AR | |
| dc.contributor.author | Bordalo, J | |
| dc.contributor.author | Ribeiro Santos, J | |
| dc.date.accessioned | 2012-12-20T16:01:19Z | |
| dc.date.available | 2012-12-20T16:01:19Z | |
| dc.date.issued | 2009 | |
| dc.description.abstract | BACKGROUND: Prospective testing for posttransplant circulating anti-HLA antibodies seems to be a critical noninvasive tool, but confirmatory data are lacking. MATERIALS AND METHODS: Over the last 3 years, peritubular capillary (PTC) C4d deposition was prospectively sought by an immunofluorescence technique applied to frozen tissue in biopsies obtained for allograft dysfunction. Screening for circulating anti-HLA class I/II alloantibodies (AlloAb) by the flow cytometric test was performed simultaneously. RESULTS: We evaluated 132 sets of biopsies and simultaneous serum samples. PTC C4d deposition was demonstrated in 15.9% (21/132) of biopsies. Circulating anti-HLA I/II AlloAb were detected in 25% (33/132) of serum samples. Employing receiver-operator characteristic (ROC) curves for all C4d-positive biopsies, screening for AlloAb showed a global specificity of 82% and sensitivity of 61.9%. When this analysis was restricted to biopsies obtained in the first month posttransplantation, the sensitivity increased to 81.8%, but the specificity decreased to 76.9%. After the first month posttransplantation, we observed sensitivity of 40.0% and a specificity of 86.4%. In the first month posttransplantation, all patients with a diagnosis of acute antibody-mediated rejection displayed circulating anti-HLA class I/II, but not always at the same time as the C4d-positive biopsy. CONCLUSIONS: In the first month posttransplantation, prospective monitoring of anti-HLA antibodies may be useful. The high sensitivity allows the identification of patients at risk, affording an earlier diagnosis of antibody-mediated rejection. After the first month, the test can be used to evaluate allograft dysfunction episodes, since positivity is highly suggestive of an antibody-mediated process. | por |
| dc.identifier.citation | Transplant Proc. 2009 Apr;41(3):859-61 | por |
| dc.identifier.uri | http://hdl.handle.net/10400.17/903 | |
| dc.language.iso | eng | por |
| dc.peerreviewed | yes | por |
| dc.publisher | Elsevier | por |
| dc.subject | Marcadores Biológicos | por |
| dc.subject | Biópsia | por |
| dc.subject | Complemento C4b | por |
| dc.subject | Citometria de Fluxo | por |
| dc.subject | Antigénio HLA | por |
| dc.subject | Antigénio HLA-D | por |
| dc.subject | Antigénio de Histocompatibilidade Classe I | por |
| dc.subject | Transplantação de Rim | por |
| dc.subject | Fragmentos de Peptídeos | por |
| dc.subject | Reoperação | por |
| dc.subject | Sensibilidade e Especificidade | por |
| dc.subject | Transplante Homólogo | por |
| dc.title | Specificity and Sensitivity of Screening for Anti-HLA Antibodies in Kidney Allograft Dysfunction | por |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 861 | por |
| oaire.citation.startPage | 859 | por |
| oaire.citation.title | Transplantation Proceedings | por |
| rcaap.rights | openAccess | por |
| rcaap.type | article | por |