Complement-dependent cytotoxicity crossmatch in solid organ transplantation: The gold standard or golden history?

In current clinical practice, transplant clinicians create collaborative working relationships with histocompatibility laboratory scientists to identify the risk of long‐term graft failure, which may assist in establishing strategies for treatment and surveillance. Transplant immunology research also focuses on optimizing human leukocyte antibody tissue typing and defines the most effective test for detecting the presence of donor‐specific antibodies. Although several studies have been conducted, data on pediatric heart transplant recipients are limited. Epitope load information may be utilized to identify donors with permissible human leukocyte antibody mismatches to increase transplant success. Although current guidelines do not consider human leukocyte antibody epitope‐based matching tools, these guidelines could be useful for identifying recipients at a high risk of donor‐specific antibody production, which would be appropriate for routine donor‐specific antibody screening to initiate early interventions to prevent antibody‐mediated rejection. Human leukocyte antibody matching at the epitope level offers an effective approach for identifying acceptable mismatches in sensitized patients and provides information about epitope loads. In the future, eplet matching may be used to define the best immunosuppressive therapy protocol for cardiothoracic organ transplantation. This report provides an overview of the role of human leukocyte antibodies in heart and lung transplantation.

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Crossmatch and Histocompatibility

Paul,

Chellammal Arun Dileep,

Gracious

2024

Bridging the Gap and Saving Lives - A Comprehensive Guide to Organ Donation [Working Title]

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Chronic kidney disease is a worldwide public health problem for which kidney transplantation results in an improved quality of life and social rehabilitation, and savings in overall healthcare costs. The human leukocyte antigen (HLA) system, also known as the major histocompatibility complex (MHC) in humans, plays a crucial role in the immune system. It is responsible for producing cell surface molecules that are specifically designed to convey antigenic peptides to the T-cell receptor (TCR) found on T cells. HLA determines whether a patient has already developed antibodies against the donor’s antigens. Various platforms for crossmatching include CDC Crossmatch (CDC CXM), Flow cytometric crossmatch (FCXM), Luminex-based DSA Lysate crossmatch, and Virtual Crossmatch (VXM). VXM is a procedure used to determine the compatibility between a potential organ donor and recipient without physically mixing their blood samples. VXM does not function as a standalone laboratory test; instead, it depends on the analysis and interpretation of prior data obtained from the recipient’s anti-HLA analysis using Single Antigen Bead (SAB) assays and donor HLA molecular type. Epitope-based matching is a novel method of histocompatibility matching that involves estimation of the eplet against the antibody in the recipient’s serum based on the positive reaction pattern observed in the SAB assay.

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Complement-dependent cytotoxicity crossmatch in solid organ transplantation: The gold standard or golden history?

Cited by 3 publications

References 21 publications

Repeated human leukocyte antigens eplets, importance of typing the partner

Repeated human leukocyte antigens eplets, importance of typing the partner

Role of HLA in cardiothoracic transplantation

Crossmatch and Histocompatibility

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