Riethmüller S Ferrari-Lacraz S Müller MK Raptis DA Hadaya K Rüsi B Laube G Schneiter G Fehr T Villard J 2010 BACKGROUND This study evaluated the prognostic impact of pretransplant donor-specific anti-human leukocyte antigen antibodies (DSA) detected by single-antigen beads and compared the three generations of crossmatch (XM) tests in kidney transplantation. METHODS Thirty-seven T-cell complement-dependent cytotoxicity crossmatch (CXM) negative living donor kidney recipients with a retrospectively positive antihuman leukocyte antigen antibody screening assay were included. A single-antigen bead test, a flow cytometry XM, and a Luminex XM (LXM) were retrospectively performed, and the results were correlated with the occurrence of antibody-mediated rejections (AMRs) and graft function. RESULTS We found that (1) pretransplant DSA against class I (DSA-I), but not against class II, are predictive for AMR, resulting in a sensitivity of 75% and a specificity of 90% at a level of 900 mean fluorescence intensity (MFI); (2) with increasing strength of DSA-I, the sensitivity for AMR is decreasing to 50% and the specificity is increasing to 100% at 5200 MFI; (3) the LXM for class I, but not for class II, provides a higher accuracy than the flow cytometry XM and the B-cell CXM. The specificity of all XMs is increased greatly in combination with DSA-I values more than or equal to 900 MFI. CONCLUSIONS In sensitized recipients, the best prediction of AMR and consecutively reduced graft function is delivered by DSA-I alone at high strength or by DSA-I at low strength in combination with the LXM or CXM. https://sonar.ch/global/documents/244197 eng info:eu-repo/semantics/altIdentifier/doi/10.1097/tp.0b013e3181e36e08 info:eu-repo/semantics/altIdentifier/pmid/20658760 Transplantation. - 2010 Adult Female Flow Cytometry Graft Rejection HLA Antigens Histocompatibility Testing Humans Immunosuppression Isoantibodies Kidney Transplantation Living Donors Lymphocytes Male Middle Aged Prognosis ROC Curve Reoperation Retrospective Studies Tissue Donors Donor-specific antibody levels and three generations of crossmatches to predict antibody-mediated rejection in kidney transplantation. http://purl.org/coar/resource_type/c_6501