Analysis of Panel Reactive Antibodies in Renal Transplant Recipients Detected by Luminex: A Single-Center Experience.

OBJECTIVES: The role of panel reactive antibody has gained universal acceptance in solid-organ transplant. This parameter is used to gauge the level of sensitization of prospective solid-organ recipients. More than one-third of patients on wait lists for kidney transplant are sensitized. Most have previously formed donor-specific and non-donor-specific serum antibodies and/or positive crossmatch by complement-dependent cytotoxicity and/or flow cytometry. We present the rate of positivity at our institution for human leukocyte antigen antibodies and describe the condensation of antibodies in human leukocyte antigens for renal pretransplant recipients. MATERIALS AND METHODS: Between January 2011 and December 2012, six hundred twenty consecutive renal transplant recipients on the wait list at the Baskent University were evaluated for this retrospective study. Panel reactive antibody screening and definition tests were studied with Luminex assays for the combination of class I (A, B, C) and class II antigens (DR, DQ). RESULTS: We found a panel reactive antibody screening positivity in 20.4% of our patients on renal transplant waiting list. Panel reactive antibody defining tests were meaningful in 12.2% of the whole list. We observed that only panel reactive antibody class I positivity was seen in 2.2%, only panel reactive antibody class II positivity was seen in 2.7%, and both panel reactive antibody class I and class II positivities were seen in 7.2% of the defining tests. CONCLUSIONS: The estimated risk of sensitization for patients with a living donor is determined from the combined results of the crossmatch with the donor and those of the recipient's panel reactive and donor-specific antibodies. Compared with complement-dependent cytotoxicity crossmatch, Luminex assays provide greater sensitivity and specificity in detection of donor-specific antibodies.