Background
HLA antibodies have been shown to play a significant role in transplantation rejection. Screening for HLA antibodies in donors is essential for diagnosis prior to transplantation and serves as a monitoring tool post-transplantation. The specificities of HLA antibodies in patients on the transplant waiting list are believed to correlate with HLA frequency. In this study, we aimed to investigate the positive rates and specificity of HLA antibodies while observing the HLA frequency in Taiwan.
Methods and Materials
We conducted a comprehensive analysis of total of 1193 sera from northern Taiwan hospitals between January 2021 and April 2023. 518 sera were tested for HLA screening and 675 sera were tested for panel-reactive antibodies (%PRA). Luminex-PRA tests were performed using LIFECODES® LifeScreen Deluxe kits and LIFECODES® Class I and Class II ID (Immucor Transplant Technology, Stamford, CT, USA). The results could provide valuable insights into different strategies for detecting anti-HLA antibodies and screening approaches.
Results
Our findings the overall positive rates of PRA were 15.8% in HLA antibodies screening and 14.4% for HLA class I, 19.4% for HLA class II, and 19.1% for both antibodies in %PRA, respectively and with significant difference between two Luminex PRA methods (P<0.001). In HLA antibodies screening tests, only positive for class I was 5.2%, only positive for class II was 4.6% and for both was 6.0%. The serial positive rates were declined yearly for both HLA antibodies from 27.6% to 6.6% between 2021 and 2023. It may be more cost-effective and practical to perform testing for %PRA specifically for patients with positive screening results.
Conclusions
Our study suggested the monitoring of anti-HLA antibodies prevalence for assisting clinicians and policymakers in implementing an effective strategy for antibodies screening.