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Related Experiment Videos

Crossmatching technique facilitating kidney transplantation

B Buabut1, P Chiewsilp, K Patanapanyasat

  • 1Department of Pathology, Pramongkutklao Hospital, Bangkok, Thailand.

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|November 5, 1997
PubMed
Summary

Flow cytometric crossmatching (FCXM) is the most sensitive technique for detecting preformed antibodies, but antihuman globulin crossmatching (AHG) is more practical for routine kidney transplantation, especially for sensitized patients.

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Area of Science:

  • Nephrology
  • Immunology
  • Transplantation Science

Background:

  • Accelerated acute cellular rejection (AR) remains a significant challenge in kidney transplantation (KT).
  • Undetected presensitization, indicated by preformed antibodies, is a likely cause of AR.
  • Accurate crossmatching (XM) is crucial for identifying patients at risk.

Purpose of the Study:

  • To evaluate the sensitivity of different crossmatching techniques in detecting preformed antibodies.
  • To identify the most effective crossmatching method for preventing AR in kidney transplant recipients.

Main Methods:

  • Compared standard NIH, antihuman globulin (AHG), and flow cytometric crossmatching (FCXM) techniques.
  • Tested 122 sera from 98 kidney transplant candidates against 23 cadaveric splenic lymphocyte panels.

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  • Utilized anti-HLA-A2 titrations to assess the sensitivity of each technique.

    • Main Results:

    • FCXM demonstrated the highest sensitivity, followed by AHG, and then standard NIH.
    • AHG and FCXM detected positive results missed by standard NIH in several cases.
    • AHG effectively detected both IgG and IgM anti-donor antibodies, while FCXM had limitations with IgM detection.

    Conclusions:

    • FCXM is superior in sensitivity for detecting preformed antibodies.
    • AHG crossmatching offers a practical and sensitive alternative for routine use, particularly for living-related KT and sensitized patients.
    • AHG is more sensitive than standard NIH and does not require complex instrumentation.