The crossmatch may still be the most clinically relevant histocompatibility test performed

Area of Science:

• Transplantation immunology
• Clinical diagnostics

Background:

• Accurate prediction of transplant success is vital for patient outcomes.
• Current methods for antibody screening and crossmatching require careful evaluation.

Purpose of the Study:

• To evaluate the correlation between pre-transplant antibody screening methods and actual graft survival.
• To determine the reliability of virtual crossmatch predictions compared to real-time crossmatches.

Main Methods:

• Patient sera were analyzed using flowPRA (flow-cytometric panel reactive antibody), FCXM (flow cytometry crossmatch), and end-point donor-antigen titer.
• Results from these assays were correlated with clinical outcomes, specifically graft survival.

Main Results:

• A positive or negative FCXM result cannot be accurately predicted without performing the actual crossmatch.
• Even in the presence of donor-specific antigens, virtual evaluation is insufficient.
• Fluorescence intensity, used as a surrogate for antibody concentration, does not quantitatively correlate with crossmatch outcomes.

Conclusions:

• Real-time crossmatching is imperative for offering donor organs to recipients.
• Reliance on virtual evaluations alone is insufficient for accurate crossmatch prediction.
• Performing a direct crossmatch is essential for optimizing transplant eligibility and outcomes.