CLINICAL RELEVANCE OF DONOR SPECIFIC ANTIBODIES (DSA) DETECTED BY LUMINEX TECHNOLOGY: AN EARLY SYSTEMATIC REVIEW AND META-ANALYSIS OF THE LITERATURE FOR A HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT PROJECT

Background. Aim of this work is to provide a meta-analysis to evaluate the clinical relevance of donor speci c antibodies (DSA) detected by Luminex technology, in order to produce quantitative clinical data for a Hospital-Based Health Technology Assess- ment project. Methods. We performed a literature search using the Medline database and critically appraised all relevant articles. The search terms used were “Luminex”,“transplantation”, and “HLA typing”. Studies referring to DSA detected by Luminex on pa- tients undergone transplantations were considered. Articles were subsequently divided into three subgroups: acute rejection AR and 1 year (5 years or more) post transplant graft failures 1GF (5 GF). A meta-analysis was then performed for each group using the odds-ratio (random effects) method in order to compare transplantation outcomes among patients in presence or not of DSA. Results. 10 trials were selected, collecting a total of 913 patients for the AR group, 266 patients for 1GF and 1846 patients for 5GF. Pooled comparison of study outcomes showed that the incidence of both acute rejection and post transplant graft failure increased in the case of DSA detected by Luminex. Combined odds ratio (con dence interval 95%) for AR, 1GF and 5GF groups were in fact 2.34 (0.59-9.37), 3.41 (1.47-7.88) and 1.85 (1.08-3.17), respectively. Conclusions. Our meta-analysis con rmed the capability of Luminex technology to provide a clinical support in predicting both acute rejection and late graft failure. We cannot fully exclude the possibility of centre biases in treatments and selection patients and well-designed trials need to carry out in the future.