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Journal of Transplantation
Volume 2016 (2016), Article ID 2106028, 8 pages
http://dx.doi.org/10.1155/2016/2106028
Research Article

C1Q Assay Results in Complement-Dependent Cytotoxicity Crossmatch Negative Renal Transplant Candidates with Donor-Specific Antibodies: High Specificity but Low Sensitivity When Predicting Flow Crossmatch

1Department of Transplantation, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez, Sección XVI, Tlalpan, 14080 Mexico City, Mexico
2Histocompatibility Laboratory, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez, Sección XVI, Tlalpan, 14080 Mexico City, Mexico
3Department of Nephrology-Mineral Metabolism, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez, Sección XVI, Tlalpan, 14080 Mexico City, Mexico

Received 29 March 2016; Revised 22 June 2016; Accepted 13 July 2016

Academic Editor: Andreas Zuckermann

Copyright © 2016 José M. Arreola-Guerra et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The aim of the present study was to describe the association of positive flow cross match (FXM) and C1q-SAB. Methods. In this observational, cross-sectional, and comparative study, patients included had negative AHG-CDC-XM and donor specific antibodies (DSA) and were tested with FXM. All pretransplant sera were tested with C1q-SAB assay. Results. A total of 50 donor/recipient evaluations were conducted; half of them had at least one C1q+ Ab (, 52%). Ten patients (20.0%) had DSA C1q+ Ab. Twenty-five (50%) FXMs were positive. Factors associated with a positive FXM were the presence of C1q+ Ab (DSA C1q+ Ab: OR 27, 2.80–259.56, , and no DSA C1q+ Ab: OR 5, 1.27–19.68, ) and the DSA LABScreen-SAB MFI (OR 1.26, 95% CI 1.06–1.49, ). The cutoff point of immunodominant LABScreen SAB DSA-MFI with the greatest sensitivity and specificity to predict FXM was 2,300 (sensitivity: 72% and specificity: 75%). For FXM prediction, DSA C1q+ Ab was the most specific (95.8%, 85–100) and the combination of DSA-MFI > 2,300 and C1q+ Ab was the most sensitive (92.0%, 79.3–100). Conclusions. C1q+ Ab and LABScreen SAB DSA-MFI were significantly associated with FXM. DSA C1q+ Ab was highly specific but with low sensitivity.