The CDC crossmatch in the era of flow cytometric cross-match and single antigen beads

Mahowald, Grace K.

doi:10.1590/2175-8239-jbn-2021-0110

Cited by 5 publications

(5 citation statements)

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“…Between 2013 and 2022, the CDC-XM test was administered to 146 patients. The CDC-XM is a test that determines a patient's donor-specific antibodies by reacting the donor's lymphocytes with the patient's serum prior to kidney transplantation [ 12 ]. After excluding duplicate results from repeated assays, 54 patients remained.…”

Section: Resultsmentioning

confidence: 99%

Recent trends in perioperative blood transfusion during elective kidney transplantation

Roh,

Park,

Kang

2023

Korean J Transplant

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Background Accurately predicting the demand for blood transfusions is crucial for blood banks. Given the potential for emergency situations, it is imperative that blood banks maintain a sufficient inventory of blood products. In this study, we examined the use of perioperative transfusions in patients undergoing elective kidney transplants. Methods Data on all complement-dependent cytotoxicity-crossmatched assays between 2013 and 2022 were collected. We excluded repeated assays and patients who did not undergo kidney transplantation. Transfusion records and transfusion adverse reactions were reviewed retrospectively. Results In total, 30 patients underwent elective kidney transplantation from 2013 to 2022. The mean age of the patients was 48.1±9.7 years. The male-to-female ratio was 1.51. Four patients received transfusions intraoperatively, whereas eight patients were transfused postoperatively. The postoperative hemoglobin level of the transfusion group (n=9, 8.9±1.3) was significantly lower than that of the nontransfusion group (n=21, 10.4±1.2). The most commonly transfused blood product intraoperatively was leuko-reduced filtered red blood cells, followed by fresh frozen plasma. When the study period was divided into two halves based on the time of operation, the first half showed a higher number of significant transfusions. Conclusions In most elective kidney transplant cases, surgery was conducted without the need for blood transfusion. The timing of transfusion, when necessary, shifted from during the operation to after the operation. The implementation of patient blood management, coupled with advancements in surgical techniques, appears to have impacted the pattern of perioperative transfusion.

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Section: Resultsmentioning

confidence: 99%

Recent trends in perioperative blood transfusion during elective kidney transplantation

Roh,

Park,

Kang

2023

Korean J Transplant

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“…Depending on the recommendations in individual countries, various methods are used, starting from the biological method PRA-CDC (Panel Reactive Antibodies-Complement Dependent Cytotoxicity) performed in the potential recipient from the moment of entering the transplant waiting list until the procedure is performed, through tests with higher resolution, such as SPA (Solid Phase Assay) using a flow fluorimeter (Luminex), flow cytometer or ELISA technique, allowing to identify the specificity of anti-HLA antibodies and differentiate their classes [2,8,16,17]. These tests should include assessing antibodies in the group of potential recipients and monitoring the humoral response in transplant patients.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the level of alloantibodies and selected cytokines in kidney recipients

Wojciechowska‐Koszko¹,

Nowosiad-Magda²,

Krasnodębska-Szponder³

et al. 2022

J Pre Clin Clin Res.

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Introduction and Objective. Anti-HLA antibodies, especially anti-DSA, are believed to be potentially involved in acute and chronic rejection. New techniques, e.g. flow fluorimetry, can be an excellent supplement to the lymphocytotoxic tests currently used in pre-transplantation practice, and become a tool for monitoring post-transplant immunisation. The aim of the study was to assess the level of cytokines and alloimmunisation in kidney recipients, with the histopathological evaluation of the transplanted kidney biopsy. Materials and method. The study included 62 graft recipients six months after transplant. The level of anti-HLA antibodies was assessed using the x-Map Luminex technique, and the level of cytokines (IFN-γ, IL-4, IL-10, IL-17) was determined using the ELISA test. Results. Histopathological analysis showed that more than 45.2% of patients had changes in the biopsy material. Analysis of the level of alloimmunisation showed that in over 75.8%, the presence was detected of anti-HLA IgM class I antibodies, while anti-HLA IgM class II antibodies were found less often -17.8%. The level of anti-HLA IgG antibodies, depending on the type of the assessed class, respectively, was: class I -43.5% and class II -50%. More than half of the subjects also had anti-MICA antibodies. The level of analysed cytokines was low. Conclusions. The results indicate significant alloimmunisation of kidney recipients, although they do not answer the question whether these are antibodies that appeared de novo after transplantation, and whether anti-DSA antibodies were present among them. For this purpose, the diagnostics should be expanded to include anti-HLA monitoring in the pre-and post-transplant period, using screening tests and tests to identify their specificity. The protocol biopsy and examination of level cytokine can also be a helpful tool in post-transplant diagnosis.

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“…Similar to the CDC-XM, the FCXM fails to distinguish between HLA and non-HLA antibodies but offers higher sensitivity and does detect both complement fixing and non-complement fixing DSA. Solid phase antibody detection methods have helped overcome some of the above-mentioned limitations (Mahowald, 2021). XM results are often interpreted in reference to single antigen bead (SAB) analysis to permit attribution of reactivity.…”

Section: Detection and Definition Of Hla Antibodiesmentioning

confidence: 99%

“…Routine detection of HLA antibodies is provided for by a range of methodologies. The complement‐dependent cytotoxicity crossmatch (CDC‐XM), introduced in the 1960s (Patel & Terasaki, 1969), uses the activation of the complement classical pathway to determine the presence of donor‐specific antibody (DSA) (Mahowald, 2021). Recipient serum is added to donor lymphocytes followed by addition of complement – subsequent donor cell cytotoxicity is the consequence of DSAs in the recipient's serum (Mulley & Kanellis, 2011).…”

Section: Detection and Definition Of Hla Antibodiesmentioning

confidence: 99%

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Forming a new perspective: Post‐structural approaches to determination of donor compatibility and post‐transplant assessment of allograft health

Nadat,

Clark

2024

Int J Immunogenetics

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The purpose of this review is to encourage a new perspective on the question of donor–recipient compatibility and post‐transplant assessment of graft health based on functional measures. The premise is that we should be better sighted on what (and how) the immune system responds toward rather than what is merely there. Continuance of the pursuit of further and better definition of antigens and antibodies is not however discouraged but seen as necessary to improved understanding of the structural correlates of functional immunity. There currently exists, in the opinion of the authors, an opportunity for histocompatibility and immunogenetics laboratories to develop and widen their scope of involvement into these new areas of laboratory activity in support and to the benefit of the transplant programmes they serve.

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The CDC crossmatch in the era of flow cytometric cross-match and single antigen beads

Abstract: The CDC crossmatch in the era of flow cytometric crossmatch and single antigen beadsA prova cruzada por CDC na era da prova cruzada por citometria de fluxo e grânulos de antígeno único

Cited by 5 publications

References 7 publications

Recent trends in perioperative blood transfusion during elective kidney transplantation

Recent trends in perioperative blood transfusion during elective kidney transplantation

Evaluation of the level of alloantibodies and selected cytokines in kidney recipients

Forming a new perspective: Post‐structural approaches to determination of donor compatibility and post‐transplant assessment of allograft health

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