C1Q Assay Results in Complement-Dependent Cytotoxicity Crossmatch Negative Renal Transplant Candidates with Donor-Specific Antibodies: High Specificity but Low Sensitivity When Predicting Flow Crossmatch. (4th September 2016)

• Record Type: Journal Article
• Authors: Arreola-Guerra, José M.; Castelán, Natalia; de Santiago, Adrián; Arvizu, Adriana; Gonzalez-Tableros, Norma; López, Mayra; Salcedo, Isaac; Vilatobá, Mario; Granados, Julio; Morales-Buenrostro, Luis E.; Alberú, Josefina
• Other Names: Zuckermann Andreas Academic Editor.
• Is Part Of: Journal of transplantation. Volume 2016(2016)
• Publication Date: 2016-09-04
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95405
• DOI: 10.1155/2016/2106028
• Languages: English
• ISSNs: 2090-0007

Abstract

Abstract : The aim of the present study was to describe the association of positive flow cross match (FXM) and C1q-SAB. Methods . In this observational, cross-sectional, and comparative study, patients included had negative AHG-CDC-XM and donor specific antibodies (DSA) and were tested with FXM. All pretransplant sera were tested with C1q-SAB assay. Results . A total of 50 donor/recipient evaluations were conducted; half of them had at least one C1q+ Ab (n = 26, 52%). Ten patients (20.0%) had DSA C1q+ Ab. Twenty-five (50%) FXMs were positive. Factors associated with a positive FXM were the presence of C1q+ Ab (DSA C1q+ Ab: OR 27, 2.80–259.56, P = 0 . 004, and no DSA C1q+ Ab: OR 5, 1.27–19.68, P = 0 . 021 ) and the DSA LABScreen-SAB MFI (OR 1.26, 95% CI 1.06–1.49, P = 0 . 007 ). The cutoff point of immunodominant LABScreen SAB DSA-MFI with the greatest sensitivity and specificity to predict FXM was 2, 300 (sensitivity: 72% and specificity: 75%). For FXM prediction, DSA C1q+ Ab was the most specific (95.8%, 85–100) and the combination of DSA-MFI > 2, 300 and C1q+ Ab was the most sensitive (92.0%, 79.3–100). Conclusions . C1q+ Ab and LABScreen SAB DSA-MFI were significantly associated with FXM. DSA C1q+ Ab was highly specific but with low sensitivity.