Browsing by Author "Picascia, Antonietta"

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    Current Concepts in Histocompatibility During Heart Transplant
    (Başkent Üniversitesi, 2012-06) Picascia, Antonietta; Crudele, Valeria; Napoli, Claudio; Mancini, Francesco P.; Sessa, Marcella; Maiello, Ciro; Infante, Teresa; Zullo, Alberto; Grimaldi, Vincenzo
    Sensitized candidates for heart transplant usually end up on a long waiting list and have an increased risk of rejection, graft loss, and incidence of cardiac allograft vasculopathy. An increasing number of studies have demonstrated the negative effect of preformed and posttransplant antibodies on graft survival. Thus, in sensitized patients, the combination of new, appropriate, desensitization protocols, and monitoring of posttransplant development of donor-specific antibodies may improve short-term and long-term outcomes. Introduction of more-sensitive and more-specific techniques for antibody detection provides a valid tool for assessing the degree of pretransplant HLA histocompatibility, and, therefore, predicting the results of crossmatch in sensitized patients, which are difficult to transplant. Currently, there are no accurate and standard methods to determine the functional characteristics of antibodies detected by solid-phase assay and, therefore, to predict their clinical relevance. Therefore, the future of heart transplantation requires a better understanding of tissue typing techniques and the effect of anti-HLA antibodies on clinical outcome to prevent discrimination against sensitized patients at the time of organ allocation.
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    Methodologies for Anti-HLA Antibody Screening in Patients Awaiting Kidney Transplant: A Comparative Study
    (Başkent Üniversitesi, 2011-12) Minucci, Pellegrino B.; Napoli, Claudio; Russo, Adolfo; Picascia, Antonietta; Sabia, Chiara; Resse, Marianna; Sommese, Linda; Cacciatore, Francesco; Casamassimi, Amelia; Grimaldi, Vincenzo
    Objectives: The relevance of anti-HLA antibodies in patients awaiting kidney transplants is well recognized. During the past 40 years, kidney transplant candidates have been tested for these antibodies, and the choice of the detection assay has become essential. Recently, the pioneer method, the complement-dependent cytotoxicity, has been integrated but has not been replaced by more-sensitive solid-phase assays, such as the enzyme-linked immunosorbent assay and the bead-based technology (ie, flow cytometry: FlowPRA, and FlowAnalyzer: Luminex). Materials and Methods: We compared the sensitivity and antibody specificity of these 4 techniques for detecting panel-reactive antibodies in a population of 101 consecutive patients awaiting a renal transplant (which had already resulted positive in a prescreening analysis). Results: Sera positive for class I and class II antibodies were 62 and 90 as assessed by the complement-dependent cytotoxicity method, 76 and 58 by using enzyme-linked immunosorbent assay, 83 and 65 with Flow-panel-reactive antibodies, and 90 and 79 by Luminex. Luminex gave more positive scores than the others for class I HLA antibodies, whereas complement-dependent cytotoxicity revealed more positives for those of class II. Conclusions: Although Luminex appears more efficient among these assays, our results indicate that use of multiple methods is still the best approach for characterizing the immunologic status of these patients.