The Crossmatch May Still Be the Most Clinically Relevant Histocompatibility Test Performed.

Kerman R, Lappin J, Kahan B, Katz S, McKissick E, Hosek K, Acorda N, Wooley N, Hoover A, Miller K, Rodriguez L, Moore B, Melcher P, Biedermann B, Van Buren C.

Clinical Transplants 2007, Chapter 23

Abstract

We evaluated patient sera for flow PRA, FCXM, and end-point donor-antigen titer, and we correlated the results with graft survival. You cannot accurately predict a positive or negative FCXM result-not even when the sera have donor-specific antigens-unless you actually perform a crossmatch. Using fluorescence intensity as a surrogate for antibody concentration does not correlate quantitatively with the occurrence of a positive or negative crossmatch. Therefore, it is imperative to give each recipient a chance at being offered a donor organ by performance of a real-time crossmatch and not rely on a virtual evaluation.