Introduction Solid-phase HLA antibody assays are sensitive and specific to identify antigen and allele-level specificities. Protocol changes to test frequency and the addition of FlowPRA bead (FPB) screening to monitor HLA antibodies in renal patients required post-implementation monitoring. This study correlated Luminex single-antigen bead (SAB) and FPB test results to monitor the effectiveness of these changes. Methods SAB for antibody ID and FPB for screening are performed quarterly on actively-waitlisted renal recipients. This study evaluated agreement based on current SAB positive cutoff MFI values: 3000 for HLA-A and -B, 5000 for HLA-C and 1000 for all Class II specificities. Class II results with cutoff ⩾3000 were included to gauge sensitivity. The current FPB positive cutoff is ⩾5% over the negative control. Results 615 serum samples from 261 patients tested within a 15-month window after FPB implementation were evaluated for agreement by patient number and number of samples tested. Patient Numbers : SAB and FPB Class I results did not agree in 84 patients (32.2%); 63.1% of patients had false positive (FP) and 36.9% had false negative (FN) results. With a MFI ⩾1000 cutoff, Class II results did not agree in 119 patients (45.6%); 0.8% of patients had FP and 99.2% had FN results. With a MFI ⩾3000, Class II results did not agree in 49 patients (18.8%); 18.4% of patients had FP and 81.6% had FN results. Sample Numbers : SAB and FPB Class I results did not agree in 162 serum samples (26.3%); 60.5% of samples had FP and 39.5% had FN results. With a MFI ⩾1000 cutoff, Class II results did not agree in 312 samples (50.7%); 11.9% of samples had FP and 88.1% had FN results. With a MFI ⩾ 3000 cutoff, Class II results did not agree in 128 samples (20.8%); 33.6% of samples had FP and 66.4% had FN results. Conclusion HLA antibody monitoring is important to anticipate donor-specific reactivity in renal transplant recipients. If ID and screening assays are used to monitor these levels, an acceptable degree of correlation between methods is important. The FPB assay is not as sensitive or specific as SAB, especially in detecting weak, clinically-significant specificities. This study identified weakness in our protocol, leading us to evaluate other HLA antibody assay options.