Reassessment of Virtual Crossmatch: The Clinical Meaning of Cell-Based Actual Crossmatch for Kidney Transplantation

B. Peng,^1,2 M. Yu,^1,2 Q. Zhuang,^1,2 H. Liu,^1,2 L. Zhu,^1,2 Y. Liu,^1,2 K. Cheng,^1,2 Y. Ming.^1,2

¹Transplantation Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
²Engineering & Technology Research Center for Transplantation Medicine, National Ministry of Health, Changsha, Hunan, China.

Meeting: 2018 American Transplant Congress

Abstract number: C14

Keywords: Allocation, Antibodies, Kidney transplantation, Rejection

Session Information

Session Name: Poster Session C: Histocompatibility and Immunogenetics

Session Type: Poster Session

Date: Monday, June 4, 2018

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall 4EF

Background: Due to the high sensitivity and specificity of Luminex technique, the Luminex single antigen beads (LSAB) assays are widely used in detecting the HLA antibodies for patients waiting for kidney transplantation. Virtual crossmatch (VXM) based on LSAB and HLA typing is one of the most important evidences for kidney allocation. However, the VXM result is not always consistent with cell-based actual crossmatch (AXM) performed by flow cytometry. The clinical meaning of these two strategies is still poorly elucidated.

Methods: From August 2017 to October 2017, a total of 137 cases in our center were assessed by LSAB, cell-based flow cytometric crossmatch (FXM) and flow cytometric complement-dependent cytotoxicity (F-CDC) assays. Among them, 50 patients received kidney transplantation. The consistency within these assays, as well as the correlation between crossmatch result and short-term clinical prognosis, was analyzed.

Results: Donor specific antibodies (DSA) were detected in 38 cases (27.74%) by LSAB, while only 14 cases (10.22%) and 9 cases (6.57%) were positive in FXM and F-CDC. The consistency of VXM/FXM, VXM/F-CDC and FXM/F-CDC was 73.72%, 75.91% and 87.59%, respectively. The results of these three assays remained consistent in 94 cases (68.61%), 92 cases all negative and 2 case all positive. In 50 kidney transplant recipients, 9 recipients had DSA detected by LSAB but remained negative in FXM and F-CDC, and none of them suffered from hyperacute rejection or accelerated acute/acute rejection, but 1 had delayed graft function (DGF). The other 41 DSA negative recipients also did not experience hyperacute rejection, but 14 of them had DGF and 3 had acute rejection.

Conclusions: Kidney allocation determined by VXM based on LSAB may deprive the opportunity from highly sensitive patients, who originally have little chance to receive transplantation. Recipients with DSA but negative AXM results has good short-term prognosis, suggesting the importance of cell-based AXM in clinical decision.

CITATION INFORMATION: Peng B., Yu M., Zhuang Q., Liu H., Zhu L., Liu Y., Cheng K., Ming Y. Reassessment of Virtual Crossmatch: The Clinical Meaning of Cell-Based Actual Crossmatch for Kidney Transplantation Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Peng B, Yu M, Zhuang Q, Liu H, Zhu L, Liu Y, Cheng K, Ming Y. Reassessment of Virtual Crossmatch: The Clinical Meaning of Cell-Based Actual Crossmatch for Kidney Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/reassessment-of-virtual-crossmatch-the-clinical-meaning-of-cell-based-actual-crossmatch-for-kidney-transplantation/. Accessed May 16, 2025.

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