Pretransplant donor-specific antibodies in cytotoxic negative crossmatch
kidney transplants: are they relevant?
Once a donor organ becomes available, the unacceptable antigen profile helps determine which candidate recipients have a high likelihood of a negative crossmatch
. A flow cytometric crossmatch is then performed for sensitized patients and, when negative, the patient is eligible to proceed to transplantation.
, patients with high panel reactive antibody (PRA scores) but negative crossmatch
who received pretransplant rituximab (n = 32) had significantly lower risk of ABMR and higher 3year graft and patient survival rates (P = 0.007 and P = 0.037, resp.).
To qualify for this type of experimental kidney transplant, the donor and recipient pairs must be blood-type compatible and have a negative crossmatch
, which means that testing has been done to confirm the recipient docs not have antibodies in the blood that would cause rejection of the kidney.
LifeLink's virtual crossmatching enables the import of organs from other centers and has proven invaluable to heart and lung recipients, who would wait much longer for a locally donated organ as well as a negative crossmatch
. During the final, quantitative crossmatching, relative risk for each patient is identified and assigned, and positive or negative reactions are determined true or false.