Korean J Lab Med.  2008 Oct;28(5):362-370. 10.3343/kjlm.2008.28.5.362.

Experience on Identification of Cross-Reactive Group Specificity Performed by Anti-human Globulin Panel Reactive Antibody Tests

• Sohn YH
• Cha CH
• Kim MH
• Ko SY
• Oh HB

• KMID: 1781568
• DOI: http://doi.org/10.3343/kjlm.2008.28.5.362

Abstract

BACKGROUND: Panel reactive antibody (PRA) is to screen and identify HLA antibody. Majority of antibody specificities in high-PRA are directed against cross reactive group (CREG). Thus, this study was to know the advantage of identifying CREG specificity and whether antibody specificities are changed according to CREG classification.
METHODS
HLA class I antibodies were identified from 159 sera from 108 patients in Asan Medical Center, who had shown more than 5% PRA by anti-human globulin (AHG)-complement-dependent cytotoxicity (CDC). Tail analysis-based computer program was developed to identify specificities, applying both Rodey (R-ABC) and Takemoto (T-ABC) classification. The results were also compared with those obtained when without CREG application (ABC).
RESULTS
Among 151 cases in which HLA specificities was identified, the frequency of CREG specificity was 22.5% in R-ABC and 27.2% in T-ABC. Eleven cases showed CREG specificities only in one classification. However, the individual antigen specificities in one hand were all included in the CREG identified in the other hand. CREG specificities in samples with PRA >50% (60%) were more frequently identified than those in samples with PRA < or =50% (9%) (in R-ABC, P<0.0001). Without applying CREG to interpretation, specificity was not identified in 9 cases.
CONCLUSIONS
Application of CREG enhanced the rate of antibody identification. Antibody specificities of those cases where CREG specificities were different between Rodey and Takemoto classifications were almost the same when compared at the individual antigen level. Therefore, it was thought that it makes no difference to use any one of these two classifications in interpreting PRA.

Keyword

Panel reactive antibody; Tail analysis; Computer program; Human leukocyte antigen; Antibody specificity; Cross reactive group (CREG)

MeSH Terms

Alleles
Antibodies/blood
*Antibody Specificity
Cross Reactions
HLA Antigens/genetics/*immunology
Histocompatibility Antigens Class I/immunology
Histocompatibility Testing
Humans
Kidney Transplantation
Reproducibility of Results
Retrospective Studies

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