High Resolution Typing Can Improve Accuracy and Sensitivity of the Virtual Crossmatch for Sensitized Patients – A Single Center’s Experience
1Pathology & Laboratory Medicine, Medical University of South Carolina, Charleston, SC, 2Surgery, Medical University of South Carolina, Charleston, SC, 3Medical University of South Carolina, Charleston, SC
Meeting: 2022 American Transplant Congress
Abstract number: 934
Keywords: Antibodies, Epitopes, Histocompatibility, Kidney transplantation
Topic: Basic Science » Basic Science » 11 - Histocompatibility and Immunogenetics
Session Information
Session Name: Histocompatibility and Immunogenetics
Session Type: Poster Abstract
Date: Sunday, June 5, 2022
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: The introduction of solid phase assays has significantly enhanced our ability to execute virtual crossmatches (VXMs). However, this method is not without its shortcomings. Current routine single antigen bead (SAB) testing has limited coverage of common alleles, patient antibodies to shared epitopes may be misrepresented by a dilution of the signal, and preferential binding of antibodies to certain beads within the assay can affect its interpretation. The purpose of this investigation is to improve upon the current methods by which the VXM and the selection of donors for highly sensitized patients is performed.
*Methods: We performed retrospective analysis of virtual crossmatches performed at our center from November 1, 2019 to December 1, 2021 to determine the potential benefit of high-resolution donor typing when performing VXM.
*Results: Between November 1, 2018 and December 1, 2021, our center performed 2,231 virtual crossmatches. Of those, 126 (5.6%) required high-resolution donor typing to confirm or rule out potential DSA to donor alleles. In addition, 81 (3.6%) donors had alleles that were not represented on the routine SAB testing panel. Through utilization of epitope analysis, we were able to accurately predict the physical crossmatch.
*Conclusions: The overall conclusion based on these results is that the accuracy and sensitivity of the virtual crossmatch based on SAB testing, and consequently donor selection and patient outcome, can be greatly improved with epitope analysis and the availability of high-resolution donor typing.
To cite this abstract in AMA style:
MarElia-Bennett C, Rohan V, Twombley K, Moussa O. High Resolution Typing Can Improve Accuracy and Sensitivity of the Virtual Crossmatch for Sensitized Patients – A Single Center’s Experience [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/high-resolution-typing-can-improve-accuracy-and-sensitivity-of-the-virtual-crossmatch-for-sensitized-patients-a-single-centers-experience/. Accessed December 2, 2024.« Back to 2022 American Transplant Congress