Perception Versus Reality?: Virtual Crossmatch--how to Overcome Some of the Technical and Logistic Limitations

Overview

Journal Am J Transplant

Publisher Elsevier

Specialty General Surgery

Date 2009 Jul 1

PMID 19563341

Citations 15

Authors

A R Tambur

D S Ramon

D B Kaufman

J Friedewald

X Luo

B Ho

A Skaro

J Caicedo

D Ladner

T Baker

J Fryer

L Gallon

J Miller

M M Abecassis

J Leventhal

Affiliations

Soon will be listed here.

Abstract

The goal of this work was to evaluate concordance between (a) actual flow cytometric crossmatch (FCXM) that is performed by the OPO laboratory servicing our transplant center and (b) virtual XM (vXM) prediction based on antibody identification by solid-phase methods performed in our laboratory. A total of 1586 FCXM, performed between June 2007 and September 2008, between all potential deceased donors in our region and sera from patients awaiting kidney or kidney-pancreas transplant, listed at Northwestern Memorial Hospital were evaluated. A key finding of this analysis was the understanding that a thorough vXM cannot be performed in some donor/recipient pairs due to the lack of certain antibody profile data specific to the donor in question. Obtaining more in depth and stringent information regarding antibody specificities, we demonstrate an excellent sensitivity and specificity of the vXM assays- 86.1% and 96.8%, respectively, with a positive likelihood ratio and negative likelihood ratios of 26.9 and 0.14, respectively. The vXM can serve as an outstanding tool to predict HLA compatibility between donor and recipient, with the caveat that the presence/absence of all antibodies against the potential donor and their strength have been thoroughly investigated.

Citing Articles

Impact of allele-specific anti-human leukocyte antigen class I antibodies on organ allocation.

Yeung M, Murakami N, Kafetzi M, Simmons D, Wood I, Macaskill P Am J Transplant. 2023; 23(9):1388-1400.

PMID: 37257653 PMC: 10756661. DOI: 10.1016/j.ajt.2023.05.021.

Virtual and Reality: An Analysis of the UCLA Virtual Crossmatch Exchanges.

Locke A, Hickey M, Valenzuela N, Butler C, Sosa R, Zheng Y Transplantation. 2023; 107(8):1776-1785.

PMID: 36944607 PMC: 10358445. DOI: 10.1097/TP.0000000000004586.

Virtual crossmatch for deceased donor kidney transplantation in the United States: A survey of histocompatibility lab directors and transplant surgeons.

Puttarajappa C, Tevar A, Hoffman W, Degenholtz H, Schinstock C, Gunabushanam V Hum Immunol. 2022; 84(3):214-223.

PMID: 36581507 PMC: 9991979. DOI: 10.1016/j.humimm.2022.12.001.

Technical and clinical aspects of the histocompatibility crossmatch assay in solid organ transplantation.

Arrunategui A, Ramon D, Viola L, Olsen L, Jaramillo A Biomedica. 2022; 42(2):391-413.

PMID: 35867930 PMC: 9467682. DOI: 10.7705/biomedica.6255.

Positive flow cytometry crossmatch with discrepant antibody testing results following COVID-19 vaccination.

Xu Q, Sood P, Helmick D, Lomago J, Tevar A, Zeevi A Am J Transplant. 2021; 21(11):3785-3789.

PMID: 34241963 PMC: 8441686. DOI: 10.1111/ajt.16753.

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