TY - JOUR
T1 - (F)Utility of the physical crossmatch for living donor evaluations in the age of the virtual crossmatch
AU - Sullivan, Harold C.
AU - Dean, Christina L.
AU - Liwski, Robert S.
AU - Biswas, Shilpee
AU - Goodman, Abigail L.
AU - Krummey, Scott
AU - Gebel, Howard M.
AU - Bray, Robert A.
N1 - Publisher Copyright:
© 2018
PY - 2018/10
Y1 - 2018/10
N2 - Flow cytometric crossmatches (FCXM) are routinely performed to support living-donor renal transplantation. While long a laboratory mainstay, a physical crossmatch is costly, time consuming, and frequently poses interpretative conundrums with both false-positive and false- negative results. Given the increased utilization of the virtual crossmatch (vXM) in the deceased donor setting, our aim was to assess its utility in living donor evaluations. We reviewed 100 living donor FCXMs and retrospectively performed a vXM for each pair. Seventy-five (75) cases were concordant, (i.e., FCXM−/vXM− or FCXM+/vXM+) while 25 cases were discordant; Five were vXM+/FCXM− and 20 were FCXM+/vXM−. Since donor-specific antibodies (DSA) were not detected in the 20 FCXM+/vXM− cases, these were interpreted as false-positive, i.e., due to non-HLA antibodies. Importantly, none of these patients, when transplanted across a positive FCXM, experienced early antibody mediated rejection or subsequently developed HLA DSA. These data reveal that, for the vast majority of living donor evaluations, a vXM is an acceptable vetting procedure.
AB - Flow cytometric crossmatches (FCXM) are routinely performed to support living-donor renal transplantation. While long a laboratory mainstay, a physical crossmatch is costly, time consuming, and frequently poses interpretative conundrums with both false-positive and false- negative results. Given the increased utilization of the virtual crossmatch (vXM) in the deceased donor setting, our aim was to assess its utility in living donor evaluations. We reviewed 100 living donor FCXMs and retrospectively performed a vXM for each pair. Seventy-five (75) cases were concordant, (i.e., FCXM−/vXM− or FCXM+/vXM+) while 25 cases were discordant; Five were vXM+/FCXM− and 20 were FCXM+/vXM−. Since donor-specific antibodies (DSA) were not detected in the 20 FCXM+/vXM− cases, these were interpreted as false-positive, i.e., due to non-HLA antibodies. Importantly, none of these patients, when transplanted across a positive FCXM, experienced early antibody mediated rejection or subsequently developed HLA DSA. These data reveal that, for the vast majority of living donor evaluations, a vXM is an acceptable vetting procedure.
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U2 - 10.1016/j.humimm.2018.08.001
DO - 10.1016/j.humimm.2018.08.001
M3 - Article
C2 - 30081064
AN - SCOPUS:85051092226
SN - 0198-8859
VL - 79
SP - 711
EP - 715
JO - Human Immunology
JF - Human Immunology
IS - 10
ER -