What is Luminex?
Luminex is a highly sensitive laboratory technology used to detect anti-HLA antibodies in kidney transplant candidates. HLA (Human Leukocyte Antigens) are proteins present on cell surfaces, and antibodies against them can trigger transplant rejection.
Key Uses of Luminex
- Identifies the full panel of anti-HLA antibodies in a patient
- Helps assess sensitization status before transplantation
- Guides donor selection and desensitization decisions
When is Luminex Performed?
- Before transplant to evaluate immune risk
- After transplant if antibody-mediated rejection is suspected
- In patients with previous pregnancies, blood transfusions, or organ transplants
How Does It Work?
Patient serum is mixed with color-coded beads coated with different HLA antigens. If antibodies are present, they bind to the beads and produce a measurable fluorescent signal. Each signal is reported as MFI (Mean Fluorescence Intensity), which reflects the strength of the antibody.
Example
Luminex shows a patient has antibodies against HLA-A25, HLA-B35, and HLA-DR15. This means their immune system might react if a donor organ has any of these antigens.
What is DSA?
DSA (Donor-Specific Antibodies) are antibodies in the recipient’s blood that target the specific HLA antigens present in the donor.
Why is DSA Important?
- Indicates a direct risk of antibody-mediated rejection
- Used to decide whether to proceed with transplant or consider desensitization
How is DSA Identified?
The patient’s anti-HLA antibody profile (from Luminex) is compared with the HLA typing of a specific donor. If there is a match (i.e., the patient has antibodies against any of the donor’s HLA), those are called DSA.
Example
Patient Antibodies | Donor HLA | DSA? |
---|---|---|
HLA-A25, HLA-B35, HLA-DR15 | HLA-A25, HLA-B44, HLA-DR15 | Yes (A25 and DR15 match) |
Difference Between Luminex and DSA
Feature | Luminex | DSA |
---|---|---|
Scope | All anti-HLA antibodies in patient | Only antibodies against a specific donor |
Purpose | Assess overall sensitization | Assess direct risk of rejection |
Timing | Before transplant / after sensitization | When donor is known |
Results | MFI values for each antibody | Match/mismatch with donor HLA |
Conclusion
Luminex testing gives a comprehensive view of a patient’s antibody profile, while DSA analysis zooms in on specific donor-related risks. Together, they are essential tools in transplant immunology, helping to prevent rejection and improve graft outcomes.
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