Of cells and microparticles: Assets and liabilities of HLA antibody detection

The evolution of antibody detection from cell-to bead-based technology has positively impacted the ability to allocate organs in a safe and timely manner. The devil, of course, is in the details that delineate how these assays are performed and applied and to recognize that while there have been some truly amazing technological advances (assets), they are still imperfect and subject to error (liabilities). This review identifies the strengths of HLA antibody assays, highlights their weaknesses and offers approaches for standardization.