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USING FLOWPRA SINGLE ANTIGEN BEADS TO AID HIGHLY SENSITIZED PATIENTS.
K.D. Cox, M. Sims, C.L. Murphey and J.L. Morrisey. San Antonio TX, SW Immunodiagnostics Inc.

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Transplanting highly sensitized patients presents a challenge for most transplant centers. It is difficult to identify all unacceptable antigens, crossmatches are usually positive, and finding a suitable donor can take an extremely long time. Using FlowPRA Single Antigen Beads (SA beads-One Lambda) to help in the identification of HLA antibodies in patients with high PRA’s, we have been able to identify the acceptable antigens of each patient.
LL a 33 year old female with a 100% PRA awaiting renal transplant has had 108 out of 114 (95%) positive preliminary deceased donor CDC crossmatches (XM). Additionally 7 of 7 LRD/LURD XM were also positive. Of the 115 positive XM all but 5 can be attributed to the presence of unacceptable antigens identified with the SA beads. Identification of acceptable mismatches allows patients to participate in a donor exchange program. VG a 40 year old male with a 100% PRA awaiting a renal transplant has had 178 XM in 3 years, all XM were positive. With SA beads we discovered that VG has antibodies to all antigens except his own; therefore only a 6 antigen match will work for a transplant. RG a 44 year old male with a 98% PRA was waiting for a heart transplant. All 11 of his prospective Flow XM were positive. Using data from SA beads we were able to identify acceptable potential donor antigens. With this information a suitable donor was found for this patient and he was successfully transplanted.
By using SA beads we are able to customize donor searches for highly sensitized patients. This could reduce the overall cost to the patients, and enable the centers to set up a donor exchange program that efficiently identifies potential LURD donors.