Utilization of crossmatch techniques for renal transplantation

The pre-transplant cytotoxic crossmatch test is a necessary requirement for renal transplantation to proceed. However, there is no universally accepted policy on the clinical significance of a positive flow-cytometric crossmatch despite the increasing use of this technique. Differences in clinical significance found by different groups may be due to the outcome measures used and differences in the technique. The definition of a positive crossmatch can affect the results and investigators may gain information of clinical importance by considering changes in antibody levels over a series of samples from individual patients. The use of sensitive screening methods may assist in the interpretation of crossmatch results. Pre- and post-transplant crossmatching may provide data which can be used to modify immunosuppression in patients at risk of graft dysfunction. (C) 1998 Lippincott Williams & Wilkins.