{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:19:42Z","timestamp":1788448782031,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T00:00:00Z","timestamp":1719446400000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HLA"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>Solid phase detection and identification of HLA antibodies in kidney transplantation currently relies on single antigen bead (Luminex\u00ae) assays, which is more sensitive than the previously used enzyme\u2010linked immunosorbent assays (ELISA). To evaluate the impact of more sensitive HLA testing on antibody\u2010mediated rejection (AMR) occurrence and allograft survival, we analysed 1818 renal allograft recipients transplanted between March 2004 and May 2021. In 2008, solid phase testing switched from ELISA to Luminex. We included 393 (21.6%) transplantations before and 1425 (78.4%) transplantations after transition from ELISA\u2010 to Luminex\u2010based testing. For this study, bio\u2010banked ELISA era samples were tested retrospectively with Luminex. Significantly less pretransplant DSA were found in patients transplanted with pre\u2010existing HLA antibodies in the Luminex (109\/387) versus the ELISA period (43\/90) (28% vs. 48%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Throughout histological follow\u2010up, 169 of 1818 (9.3%) patients developed AMR. After implementing Luminex\u2010based testing, the rate of AMR significantly decreased (<jats:italic>p<\/jats:italic>\u2009=\u20090.003). However, incidence of graft failure did not significantly differ between both eras. In conclusion, less patients with pretransplant DSA were transplanted since the implementation of Luminex HLA testing. Transition from ELISA\u2010 to Luminex\u2010based HLA testing was associated with a significant decrease in AMR occurrence post\u2010transplantation. Since the decline of AMR did not translate into improved graft survival, Luminex\u2010based testing has the added value of preventing low\u2010risk AMR cases. Therefore, Luminex' high sensitivity must be balanced against waiting time for a suitable organ.<\/jats:p>","DOI":"10.1111\/tan.15586","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T08:30:46Z","timestamp":1719477046000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Sensitive <scp>HLA<\/scp> antibody testing and the risk of antibody\u2010mediated rejection and graft failure"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2839-0154","authenticated-orcid":false,"given":"Tim","family":"Debyser","sequence":"first","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation Nephrology and Kidney Transplantation Research Group, KU Leuven  Leuven 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