Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Transplantation

Complementing donor-specific antibody testing

New data suggest that among kidney transplant recipients, those whose serum contains donor-specific antibodies that bind C1q fare the worst. Although these findings are intriguing, several unanswered questions remain and changing practice to include a C1q binding assay as standard of care in kidney transplantation would be premature.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Loupy, A. et al. Complement-binding anti-HLA antibodies and kidney-allograft survival. N. Engl. J. Med. 369, 1215–1226 (2013).

    Article  CAS  Google Scholar 

  2. Patel, R. & Terasaki, P. I. Significance of the positive crossmatch test in kidney transplantation. N. Engl. J. Med. 280, 735–739 (1969).

    Article  CAS  Google Scholar 

  3. Karpinski, M. et al. Flow cytometric crossmatching in primary renal transplant recipients with a negative anti-human globulin enhanced cytotoxicity crossmatch. J. Am. Soc. Nephrol. 12, 2807–2814 (2001).

    CAS  PubMed  Google Scholar 

  4. Wiebe, C. & Nickerson, P. Post-transplant monitoring of de novo human leukocyte antigen donor-specific antibodies in kidney transplantation. Curr. Opin. Organ Transplant. 18, 470–477 (2013).

    Article  CAS  Google Scholar 

  5. Freitas, M. C. et al. The role of immunoglobulin-G subclasses and C1q in de novo HLA-DQ donor-specific antibody kidney transplantation outcomes. Transplantation 95, 1113–1119 (2013).

    Article  CAS  Google Scholar 

  6. Gloor, J. M. et al. Baseline donor-specific antibody levels and outcomes in positive crossmatch kidney transplantation. Am. J. Transplant. 10, 582–589 (2010).

    Article  CAS  Google Scholar 

  7. Crespo, M. et al. Clinical relevance of pretransplant anti-HLA donor-specific antibodies: does C1q-fixation matter? Transpl. Immunol. http://dx.doi.org/10.1016/j.trim.2013.07.002.

  8. Weinstock, C. & Schnaidt, M. The complement-mediated prozone effect in the Luminex single-antigen bead assay and its impact on HLA antibody determination in patient sera. Int. J. Immunogenet. 40, 171–177 (2013).

    Article  CAS  Google Scholar 

  9. Reed, E. F. et al. Comprehensive assessment and standardization of solid phase multiplex-bead arrays for the detection of antibodies to HLA. Am. J. Transplant. 13, 1859–1870 (2013).

    Article  CAS  Google Scholar 

  10. Zeevi, A. et al. Persistent strong anti-HLA antibody at high titer is complement binding and associated with increased risk of antibody-mediated rejection in heart transplant recipients. J. Heart Lung Transplant. 32, 98–105 (2013).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Peter S. Heeger.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tinckam, K., Heeger, P. Complementing donor-specific antibody testing. Nat Rev Nephrol 9, 713–714 (2013). https://doi.org/10.1038/nrneph.2013.234

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneph.2013.234

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing