HLA ANTIBODY SCREENING - COMPARISON OF A SOLID-PHASE ENZYME-LINKED IMMUNOASSAY WITH ANTIGLOBULIN-AUGMENTED LYMPHOCYTOTOXICITY

Background. IgG antibodies to HLA class I antigens can cause hyperacut e rejection of renal allografts. Screening of sera from such transplan t candidates is laborious, time-consuming, and expensive when performe d by sensitive antihuman globulin-augmented lymphocytotoxicity (AHG-CD C). Methods. Because 60-70% of our transplant screens are negative, we evaluated a solid phase enzyme-linked method (EIA) as a potential pre screen by parallel testing 215 sera by AHG-CDC and by EIA. This EIA me thod is designed to detect only IgG antibodies, and all positive AHG-C DC sera were retested after dithiothreitol treatment. Results. There w as 96.2% concordance between the tests for IgG antibodies. Seven sera (3.25%) were positive by EIA alone, and one (0.46%) was negative by EI A alone. The EIA method was also less costly ($15.00 versus $105.00) a nd less time consuming (hours versus days) than AHG-CDC panel testing for large numbers of sera. Conclusions. We conclude that this EIA meth od is simple, sensitive, objective, and cost effective as a prescreen for HLA class I antibodies.