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High‐Tech Detection of HLA Antibodies and Complement: Prospects and Limitations

Most transplant clinicians and surgeons are familiar with the lymphocytotoxicity test to detect HLA antibodies (Abs). The concept is simple: the proportion of panel cells killed determines the percent panel reactive Ab (PRA). Currently, HLA Abs are increasingly measured by solid-phase tests with purified HLA molecules attached to either microtiter plates for enzyme immunoassays (EIAs) or to microparticles (beads) for flow cytometry. These tests have better sensitivity and specificity, but also add complexities to the interpretation of results that go well beyond the concept of ‘percent PRA’.