Graft loss continues to occur related to both acute and chronic rejection phenomenon despite the current matching and monitoring techniques. Acute rejection can be prevented by lymphocyte-based cross matching; however, there is no equivalent to detect the early signs of chronic rejection, which results in delayed graft failure, poor patient outcome and increasing burden on the transplant waiting list. Although donor specific antibodies produced against donor organs, detected by Luminex, are considered as culprits for poor graft outcomes, functional test is necessary to validate their effects. It is vital to identify precisely and timely the signs of allograft dysfunction at early stage, since it become irreversible to treat at the advanced one. The current invention describes a method that enables the detection of rejection when other methods cannot.
We are developing a novel cell-based assay that potentially mirrors the interaction between the recipient humoral immune response and the graft vascular bed. Our method is: (1) to seed a panel of microvascular endothelial cells on the plate, whose HLA typing has been characterized, (2) to incubate the endothelial cells with the recipient sera, and (3) to determine the cellular responses and define the responsiveness. Because the endothelial cells are the first and preferential targets of the allogeneic rejection, the results from this specific assay will provide clinicians with the most reliable information of transplant health status. This is also a noninvasive technique that makes the regular surveillance of transplanted organ possible. More importantly, there is no such test to date for detention transplant status in those transplanted patients.
