Luminex Crossmatch for Pre-Transplant Workup of Renal Transplants - 30 Months Experience from Indian Subcontinent

Mishra MN

doi:10.23937/2572-4045.1510039

International Journal of

Transplantation Research and Medicine ISSN: 2572-4045

Citation

Mishra MN, Turner D, Dudeja P, Lal V (2019) Luminex Crossmatch for Pre- Transplant Workup of Renal Transplants - 30 Months Experience from Indian Subcontinent. Int J Transplant Res Med 5:039. doi.org/10.23937/2572-4045.1510039

Copyright

© 2019 Mishra MN, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

RESEARCH ARTICLE | OPEN ACCESS DOI: 10.23937/2572-4045.1510039

Luminex Crossmatch for Pre-Transplant Workup of Renal Transplants - 30 Months Experience from Indian Subcontinent

Mahendra Narain Mishra^1*, David Turner², Puja Dudeja³ and Vandana Lal¹

¹Dr. Lal Path Labs Ltd., National Reference Laboratory, India

²Histocompatibility and Immunogenetics, SNBTS Royal Infirmary of Edinburgh, UK

³Associate Professor, Department of Preventive and Social Medicine, Armed Forces Medical College, India

Abstract

Background

Prior to 2013, most centers in India performed only Complement Dependent Cytotoxicity crossmatch (CDCXM) for detection of donor specific antibodies.

Aim

This study was undertaken to evaluate the usefulness of Luminex based crossmatch (LXM) for pretransplant detection of HLA class I and II donor specific IgG antibodies in patients with end stage renal disease.

Methods

Luminex Crossmatch was performed on samples from 654 patients, which included 582 first time recipients and 72 retransplants. CDC crossmatch was done for all 654 recipients. Panel Reactive Antibody (PRA) screen was performed for 352 (53.8%) recipients. Low resolution HLA typing was done by reverse Sequence Specific Oligonucleotide probes on Luminex platform.

Results

Twenty-five recipients (3.8%) had a positive CDCXM. LXM was positive in 277 samples (39.2%): HLA -class I donor specific antibodies (DSA) were detected in 40 (5.6%), class II DSA in 155 (21.9%) and both classes in 82 (11.5%) samples. High background was present in 70 (9.9%) samples - the results of which were confirmed by retesting a fresh sample or by correlation with PRA screen.

Conclusions

LXM in combination with PRA screen is useful for detection of clinically relevant HLA IgG donor specific antibodies for pretransplant workup and is a huge improvement on CDCXM.