Although the current evidence lacks high-quality, controlled studies, the currently available data provide reassurance that clinicians should recommend appropriate vaccination for their transplant patients as the risk of de novo DSA and rejection is relatively low.

SUMMARY AT A GLANCECrossmatching and tissue typing are crucial components of renal transplantation. There have however been a number of new developments in the last decade. This paper discusses current crossmatching techniques and is a very useful aid for nephrologists to interpret the crossmatch results of their patients. ABSTRACT:Crossmatching of potential renal donors against potential renal transplant recipients has been performed for over 40 years and is a mandatory component of the transplant work-up process. However, gone are the days when all that was available was the T-cell complement-dependent cytotoxicity crossmatch. There are now many more options available for determining the likelihood of donor-specific antibody-mediated responses including flow crossmatching and the 'virtual' crossmatch. In addition, assays to determine the extent of sensitization of cell-mediated responses are being examined. This article builds an understanding of modern day crossmatch interpretation using a case-based approach in order to provide a framework for the general nephrologist to determine the likely immune consequences of a particular donor-recipient pairing.

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