Evaluation of different methods for antibody titre determination in ABO-incompatible kidney transplantation.

IF 1.9 3区 医学 Q4 ANDROLOGY
Translational andrology and urology Pub Date : 2025-03-30 Epub Date: 2025-03-26 DOI:10.21037/tau-24-617
Shanshan Zhou, Qian Liu, Man Fang, Shan Shen, Ran Wang, Yanan Jing, Min Wang
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引用次数: 0

Abstract

Background: Blood type antibody-mediated rejection is considered the main obstacle to ABO blood type-incompatible kidney transplantation. Choosing an appropriate antibody-level determining method and setting a rational baseline are critical for safely conducting ABO-incompatible kidney allografts. However, due to the differences in antibody detection methods between laboratories, there is no unified baseline to confirm the true titer. Therefore, a generally applicable method must be selected to determine the level of anti-ABO antibodies before surgery, and the actual critical titer level should be set accordingly. This study aims to guide the selection of appropriate antibody titer detection methods for ABO-incompatible kidney transplant recipients by comparing the differences in titer results obtained through various detection methods.

Methods: A total of 210 ethylene diamine tetraacetic acid (EDTA)-anticoagulated samples were obtained from patients before or after ABO-I kidney transplantation in our centre. In this study, we tested immunoglobulin M (IgM) and immunoglobulin G (IgG) ABO antibody titres using different detection methods, i.e., a tube test (TT), a microcolumn gel card test (MGT), and a glass bead card test (GBT), to evaluate deviations in antibody levels.

Results: According to our results, the IgM titre presented by the TT varied less than one standard dilution from that of the MGT; while the TT resulted in a 2 to 4 titre deviation from that determined by the GBT. For IgG, the titres obtained by the MGT were always one standard dilution higher than those obtained by the TT, and the TT-based and GBT-based titres differed by 2-3 serial dilution steps.

Conclusions: It is important that clinical laboratories employ a consistent method of sample testing for a particular patient, and indicate the approach used when reporting results. A further clinical retrospective study revealed that the MGT could effectively monitor titre changes following surgery.

abo血型不相容肾移植中不同抗体滴度测定方法的评价。
背景:血型抗体介导的排斥反应被认为是ABO血型不相容肾移植的主要障碍。选择合适的抗体水平测定方法和设定合理的基线是安全进行abo血型不相容肾移植的关键。然而,由于各实验室抗体检测方法的差异,没有统一的基线来确认真实滴度。因此,术前必须选择一种普遍适用的方法来确定抗abo抗体水平,并相应设置实际的临界滴度水平。本研究旨在通过比较各种检测方法获得的抗体滴度结果的差异,指导abo血型不相容肾移植受者选择合适的抗体滴度检测方法。方法:收集我院abo - 1型肾移植前后患者210份乙二胺四乙酸(EDTA)抗凝标本。在本研究中,我们采用不同的检测方法,即试管试验(TT)、微柱凝胶卡试验(MGT)和玻璃珠卡试验(GBT),检测免疫球蛋白M (IgM)和免疫球蛋白G (IgG) ABO抗体滴度,以评估抗体水平的偏差。结果:根据我们的结果,TT显示的IgM滴度与MGT相差不到一个标准稀释度;而TT与GBT测定结果有2 ~ 4滴度偏差。对于IgG, MGT获得的滴度始终比TT获得的滴度高一个标准倍,基于TT和基于gbt的滴度相差2-3个连续稀释步骤。结论:重要的是临床实验室对特定患者采用一致的样品检测方法,并在报告结果时指出使用的方法。一项进一步的临床回顾性研究显示,MGT可以有效地监测手术后滴度的变化。
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来源期刊
CiteScore
4.10
自引率
5.00%
发文量
80
期刊介绍: ranslational Andrology and Urology (Print ISSN 2223-4683; Online ISSN 2223-4691; Transl Androl Urol; TAU) is an open access, peer-reviewed, bi-monthly journal (quarterly published from Mar.2012 - Dec. 2014). The main focus of the journal is to describe new findings in the field of translational research of Andrology and Urology, provides current and practical information on basic research and clinical investigations of Andrology and Urology. Specific areas of interest include, but not limited to, molecular study, pathology, biology and technical advances related to andrology and urology. Topics cover range from evaluation, prevention, diagnosis, therapy, prognosis, rehabilitation and future challenges to urology and andrology. Contributions pertinent to urology and andrology are also included from related fields such as public health, basic sciences, education, sociology, and nursing.
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