Enzyme linked immunosorbent assay (ELISA) as screening method for anti-paternal allo-antibodies in patients with recurrent pregnancy loss (RPL)

ObjectivesNon-HLA-specific anti-paternal antibodies (APA) have been associated with immune responses against HLA-negative trophoblast. As screening for APA by using the flow cytometric cross match (FCXM) is complicated, we evaluated the One Lambda Antigen Tray Test (OLATT) an easy screening method for antibodies in organ transplant recipients.Study designWe randomly selected 92 patients of our recurrent pregnancy loss (RPL)-clinic merely on the basis of having had at least two consecutive miscarriages at <20 weeks representing positive and negative FCXM results. Stored sera were thawed and tested by OLATT. Concordance (Kappa statistic) and conformance (Chi-square test to McNemar) of FCXM and OLATT results were analysed.ResultsOf 48 FCXM-positive patients, 38 (79.2%) were positive and 10 (20.8%) negative by OLATT. Out of 44 FCXM negative patients, 37 (84.1%) were negative and 7 (15.9%) positive by OLATT. This resulted in a positive prediction value of 84.4%, a negative prediction value of 78.7% and a highly significant concordance (κ = 0.631 (p < 0.0001; 81.5% versus 50%)) and conformance (p = 0.23) between FCXM and OLATT in RPL patients.ConclusionUsing the OLATT could substitute the FCXM in screening RPL patients for APA and this might help to more closely study the role of APA in human gestation.