Antibody Therapeutics as Interfering Agents in Flow Cytometry Crossmatch for Organ Transplantation

Author:

Kueht Michael L.1ORCID,Dongur Laxmi Priya1,Mujtaba Muhammad A.2ORCID,Cusick Matthew F.3ORCID

Affiliation:

1. Department of Surgery, Multiorgan Transplant and Hepatobiliary Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA

2. Department of Medicine, Transplant Nephrology, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA

3. Department of Pathology, Division of Histocompatibility and Immunogenetics, University of Michigan Medicine, 2800 Plymouth Rd., Building 36, Ann Arbor, MI 48109, USA

Abstract

Donor–recipient matching is a highly individualized and complex component of solid organ transplantation. Flowcytometry crossmatching (FC-XM) is an integral step in the matching process that is used to detect pre-formed deleterious anti-donor immunoglobulin. Despite high sensitivity in detecting cell-bound immunoglobulin, FC-XM is not able to determine the source or function of immunoglobulins detected. Monoclonal antibody therapeutic agents used in a clinic can interfere with the interpretation of FC-XM. We combined data from the prospectively maintained Antibody Society database and Human Protein Atlas with a comprehensive literature review of PubMed to summarize known FC-XM-interfering antibody therapeutics and identify potential interferers. We identified eight unique FC-XM-interfering antibody therapeutics. Rituximab (anti-CD20) was the most-cited agent. Daratumuab (anti-CD38) was the newest reported agent. We identified 43 unreported antibody therapeutics that may interfere with FC-XM. As antibody therapeutic agents become more common, identifying and mitigating FC-XM interference will likely become an increased focus for transplant centers.

Publisher

MDPI AG

Subject

Medicine (miscellaneous)

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