Screening for preformed antibodies
In solid organ transplant, preventing hyperacute rejection is the primary aim. The recipient serum is tested for antibodies against the commonest HLA antigens in the population ('panel'); however, the sheer number of different HLA antigens (about 15000 and ever increasing) make it a difficult test to be done manually.
In the solid phase bead assay, single/ multiple such antigens are attached to plastic beads and read by a specialised flow cytometer.
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No anti-MHC antibodies in recipient serum; transplant can proceed
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Non specific antibodies binding to beads, mostly against DQ and DP antibodies; transplant can proceed
High titre of antibodies against MHC Class II (DQ); contraindication to transplantatinon
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Very high titre of antibdies against MHC Class I; a definite contraindication to transpant
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