The occasion is when there is discordance between the results of the cell-based and virtual crossmatch and requires further workup before considering a patient for renal transplant. A case of the positive single-antigen bead (SAB) with donor-specific antibodies (DSA) against HLA-A*33:01 with negative complement-dependent cytotoxicity crossmatch and flow crossmatch was identified. The acid treatments of the beads were done to denature the antigen to understand the nature of identified DSA. There was variation in the Mean fluorescence intensity (MFI) observed in between patient sera with acid-treated beads (significantly increased) in contrast to regularly untreated SAB. This indicated additional antigens become available by the denaturation process. Hence, before making a final decision about the transplant in cases of ambiguity, SAB results should be interpreted in light of other compatibility results.

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Background: Timeline is a key factor for hematopoietic stem cell transplant (HSCT) recipient. HSCT by matched unrelated donor (MUD) is a standard definitive therapeutic approach for many hematological disorders which are not amenable to chemotherapy and other conventional treatment. Aims and Objectives: The aim of the present study was to compare the turnaround time (TAT) involved in completion of MUD HSCT workup from an Indian registry (Genebandhu) with international registries. Materials and Methods: On receipt of pre-transplant matching request through a transplant physician, patient's human leukocyte antigen (HLA) type was entered in both Genebandhu and World Marrow Donor Association search tool for initiating a “search.” The software gave the descending order of the best possible matches by performing computational analysis. The search result was considered a “match” when potential 10/10 HLA match was found. The average TAT was calculated in the middle of search request and HLA confirmatory typing (CT) and infectious disease marker (IDM). Further, TAT was also determined between the infusion of harvested stem cell product and CT and IDM. At last, the total time engaged in completion of each MUD HSCT workup was determined and compared in national versus international registries. Results: The average TAT involved in between search request and CT and IDM was 71 days in case of global registry and 67 days in case of Genebandhu. Similarly, the average TAT involved between infusion of harvested cell product and CT and IDM testing in case of donor identified in global stem cell registry was 65 days whereas 45 days in case of Genebandhu. At last, the average time associated with the finishing of a MUD workup was 136 days in case of global registry, whereas 112 days in the case of Genebandhu at P ≤ 0.05 with a 95% confidence interval. Conclusion: To conclude, the average TAT obtained through this study clearly demonstrates the advantages in terms of donor availability for MUD HSCT through the national registry.