The repercussions of implementing flow cytometry as a single HLA antibody screening technique in prospective renal transplant recipients

In an effort to replace the complement-dependent cytotoxicity test (CDC) with a more sensitive single technique we looked at flow cytometry as a possible replacement. The Flow PRA Bead technique (One Lambda) performed well in our laboratory. Although as expected this technique was more sensitive and specific than CDC, there remained 11 samples from eight patients which were flow negative, CDC positive. The results of various antibody identification tests on these samples prompted us to alter the positive selection criteria which we had been using on our routine screening with the Flow PRA Beads and persuaded us that the initial CDC result was correctly positive in nine of the 11 samples.