Luminex Crossmatch in Kidney Transplantation – Single Centre Experience

Abstract

Screening for preformed antibodies and prospective crossmatches are an essential component of pre-transplant testing. In this study, we evaluated the application of a Luminex solid-phase crossmatch (LumXm) as a routine test in clinical transplant practice. The test was performed with LIFECODES Donor Specific Antibody (DSA) kit (Immucor, USA) and verified using sera with known HLA specificities. For kit specificity and sensitivity testing we applied recipients' sera with defined HLA antibody specificities by Luminex Single Antigen bead (SAB) assays and cells from the potential donor. The clinical application was assessed comparing LumXm and flow cytometry crossmatch (FCXM) results in 44 real donor/recipient pairs. Concordant results were observed among FCXM, DSAs and LumXm in most donor/recipient combinations. The discrepancies in some cases were related to false positive HLA class II and false negative class I LumXm DSAs. In summary, the humoral alloimmune responses in transplantation should be interpreted carefully using a combination of assays, as well as the medical history of the recipient.