Blood Test Predicts Severe Organ Rejection

A new blood test helps predict which transplant patients are at risk for severe organ rejection, according to two studies presented at the annual meeting of the International Society for Heart and Lung Transplantation in Washington (DC, USA).

The enzyme-linked immunosorbent assay (ELISA) indicates if a patient has specific antibodies to fight foreign antigens. The studies showed that ELISA does a better job of identifying patients with sensitized immune systems than the less-sensitive PRA (panel reactive antibody) test based on lymphocytotoxicity. Researchers from the University of Pittsburgh (UPMC, PA, USA) obtained blood samples from 36 patients obtained within a month before transplantation and performed the ELISA test to see if results correlated with their actual clinical course. They found ELISA determined that 10 of 36 patients were susceptible to organ rejection. Five of these 10 developed severe rejection within a month, compared to three of the 16 negative-ELISA. A second study involving 75 adult lung transplant patients had similar results.

"ELISA identified children not considered sensitized by conventional PRA yet who are clearly at risk for rejection,” said Sabrina Tsao, M.D., a cardiology fellow with the pediatric heart transplant program at the university's School of Medicine. "Knowing in advance who may warrant more intense immunosuppression following heart transplantation is very useful clinical information.”

In the test, blood containing the patient's unique antibodies are put in contact with known human leukocyte antigens (HLA). If the antibodies bind with any of the antigens, the test is considered positive.




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