Immunoglobulin Class (IgG, IgM) Determination by Dithiothreitol in Sensitized Kidney Transplant Candidates

Utility of Virtual Crossmatch in Sensitized Patients Awaiting Heart Transplantation

“…22 IgM antibodies have also been implicated in triggering a positive serologic crossmatch; however, the clinical relevance of IgM in transplantation has been questioned. 23 In the setting of an incompatible serologic crossmatch, our practice has been to repeat the test after treatment of the recipient's serum with the reducing agent dithiothreitol to inactivate IgM, so that only IgG antibody is considered. The opposite situation involving an incompatible virtual crossmatch with a compatible serologic crossmatch could derive from the enhanced sensitivity of the solid-phase assay, from a threshold level that is set too low such that antibodies may be suspected but are not definitively confirmed, or from the detection of noncomplement-fixing antibodies.…”

Role of crossmatch testing when Luminex-SAB is negative in renal transplantation

“…To confirm autoantibodies as the cause of false positive results, an auto-crossmatch was needed (28).…”

An Update on Crossmatch Techniques in Transplantation

“…The former is often a result of autoantibodies in the recipient serum. This can be overcome by addition of Dithiothreitol (DTT) which helps prevent predominantly IgM autoantibody mediated complement activation and allows only IgG (donor specific antibodies) [3]. False negative reactions may occur when DSA levels are too low to result in activation of the complement cascade or if the antibodies are of the type that does not cause complement activation [4].…”