The avoidance of antibody-mediated rejection (AMR) attributed to human leucocyte antigen (HLA) antibody incompatibility remains an essential function of clinical Histocompatibility and Immunogenetics (H&I) laboratories who are supporting solid organ transplantation. Developments in HLA antibody identification assays over the past thirty years have greatly reduced unexpected positive cellular crossmatches and improved solid organ transplant outcomes. For sensitized patients, the decision to register unacceptable HLA antigen mismatches is often heavily influenced by results from solid phase antibody assays, particularly the Luminex^® Single Antigen Bead (SAB) assays, although the clinical relevance of antibodies identified solely by these assays remains unclear. As such, the identification of non-clinically relevant antibodies may proportionally increase the number of unacceptable transplant mismatches registered, with an associated increase in waiting time for a compatible organ. We reflect on the clinical relevance of antibodies identified solely by the Luminex SAB^® assays and consider whether the application of additional assays and/or tools could further develop our ability to define the clinical relevance of antibodies identified in patient sera. Improvements in this area would assist equity of access to a compatible transplant for highly sensitized patients awaiting a solid organ transplant.

中文翻译：

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实体器官移植患者临床相关移植前人白细胞抗原 (HLA) 抗体的表征方法

避免归因于人类白细胞抗原 (HLA) 抗体不相容性的抗体介导排斥 (AMR) 仍然是支持实体器官移植的临床组织相容性和免疫遗传学 (H&I) 实验室的基本功能。过去 30 年中 HLA 抗体鉴定分析的发展大大减少了意外的阳性细胞交叉匹配，并改善了实体器官移植的结果。对于敏感患者，登记不可接受的 HLA 抗原错配的决定通常受到固相抗体检测结果的严重影响，尤其是 Luminex ^®单抗原珠 (SAB) 测定，尽管仅通过这些测定鉴定的抗体的临床相关性仍不清楚。因此，非临床相关抗体的鉴定可能会成比例地增加登记的不可接受的移植错配的数量，并增加等待兼容器官的时间。我们反思了仅由 Luminex SAB ^®检测确定的抗体的临床相关性，并考虑应用额外的检测和/或工具是否可以进一步提高我们定义患者血清中发现的抗体的临床相关性的能力。这方面的改进将有助于为等待实体器官移植的高度敏感的患者公平地获得兼容的移植物。