The detection of donor-specific antibodies (DSAs) is a cornerstone in the immunological risk assessment prior to organ transplantation. The detection methods have developed rapidly during the last decade, and the evidence for clinical interpretation of results obtained by solid phase immunoassays (SPI) is slowly accumulating. Nevertheless, technical limitations and theoretical concerns still mean that “expert opinions” govern clinical decision-making when results of bead-based arrays are applied in immunological risk assessment prior to transplantation. This article underlines the prognostic value of SPI in the immunized recipient of an organ transplant while cautioning uncritical clinical interpretation of mean fluorescence intensity (MFI) as a quantitative parameter in organ transplantation based on documented as well as theoretical shortcomings of the method. The role of SPI-based detection of anti-HLA antibodies in clinical transplantation diagnostics is summarized and put into perspective of the Sensitization in Transplantation: Assessment of Risk (STAR) working group report 2017.

供体特异性抗体（DSA）的检测是器官移植之前进行免疫风险评估的基础。在过去的十年中，检测方法得到了迅速的发展，并且对由固相免疫测定（SPI）获得的结果进行临床解释的证据正在慢慢积累。尽管如此，技术上的局限性和理论上的顾虑仍然意味着，当将基于微珠的阵列的结果应用于移植前的免疫风险评估时，“专家意见”将决定临床决策。本文强调了SPI在器官移植的免疫接受者中的预后价值，同时基于该方法的文献记载和理论缺陷，警告非关键性临床解释将平均荧光强度（MFI）作为器官移植中的定量参数。总结了基于SPI的抗HLA抗体检测在临床移植诊断中的作用，并将其纳入了《移植敏感性：风险评估（STAR）》工作组2017年报告中。