“…Lymphocyte CDC or flow crossmatch is still the key analysis for donor-recipient selection in the majority of transplantation centres. The clinical relevance of pretransplant HLA-DSA detected by Luminex with simultaneous negative CDC or flow crossmatch is still under debate, and more data are required to assess its clinical use in children and adults [27,28].…”
“…Lymphocyte CDC or flow crossmatch is still the key analysis for donor-recipient selection in the majority of transplantation centres. The clinical relevance of pretransplant HLA-DSA detected by Luminex with simultaneous negative CDC or flow crossmatch is still under debate, and more data are required to assess its clinical use in children and adults [27,28].…”
“…This test is performed in the pretransplant investigation, where the anti-HLA antibodies present in the recipient's serum are defined. In past years, advances in these tests have made it possible to detect antibodies using solid-phase tests, which do not necessarily contemplate an HLA distribution that is representative of the assessed population [22], because they mostly include the global frequency of HLA alleles. Knowledge of the data on phenotypic frequency makes it possible to determine the real reactivity represented by a percentage value based on the recipient's population group.…”
“…22 Moreover, patients have undergone successful transplants with "incompatible" donors in the presence of donorspecific antibodies (DSAs) defined by the SAB assays. [23][24][25][26][27][28] HLA antigens can be entered into UNet, a secure Internet-based transplant information database created by United Network for Organ Sharing (UNOS) as "avoids," and a virtual crossmatch (VXM) can be done to reduce the risk for antibody-mediated graft loss. This has contributed to prolonged waiting times, especially among very highly sensitized patients 29,30 and has disproportionately affected pediatric patients.…”
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