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CDC Crossmatch

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Dr Shruti Tapiawala, Mumbai    28 November 2019

  • Complement-dependent cytotoxicity (CDC) remains the mainstay of pretransplant screening for human leukocyte antigen (HLA) specific antibodies.
  • Newer methods have significantly helped to increase the sensitivity and specificity of detecting antibodies of significance in acute humoral graft rejection in the recipient when interpreted in the light of the patient’s clinical picture and CDC crossmatch testing whilst accounting for inter-lab variations and technical errors.
  • Flow crossmatch and Luminex bead assays allows the identification of lower titer, possibly clinically significant anti-HLA antibodies.
  • At present, we have an incomplete understanding of low-level donor-specific, non-HLA and non-complement fixing antibodies in terms of their significance in solid organ transplant.
  • The combination of these various assays allow us to exclude insignificant antibodies from risk assessment while allowing better prognostication and preparation when more significant antibodies are identified that can potentially complicate though not preclude transplant.

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