PMID- 29312863
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240327
IS  - 2220-3230 (Print)
IS  - 2220-3230 (Electronic)
IS  - 2220-3230 (Linking)
VI  - 7
IP  - 6
DP  - 2017 Dec 24
TI  - Human leukocyte antigen typing and crossmatch: A comprehensive review.
PG  - 339-348
LID - 10.5500/wjt.v7.i6.339 [doi]
AB  - Renal transplantation remains the best option for patients suffering from end 
      stage renal disease (ESRD). Given the worldwide shortage of organs and growing 
      population of patients with ESRD, those waitlisted for a transplant is ever 
      expanding. Contemporary crossmatch methods and human leukocyte antigen (HLA) 
      typing play a pivotal role in improving organ allocation and afford better 
      matches to recipients. Understanding crossmatch as well as HLA typing for renal 
      transplantation and applying it in clinical practice is the key step to achieve a 
      successful outcome. Interpretation of crossmatch results can be quite challenging 
      where clinicians have not had formal training in applied transplant immunology. 
      This review aims to provide a worked example using a clinical vignette. 
      Furthermore, each technique is discussed in detail with its pros and cons. The 
      index case is that of a young male with ESRD secondary to Lupus nephritis. He is 
      offered a deceased donor kidney with a 1-0-0 mismatch. His complement dependent 
      cytotoxicity (CDC) crossmatch reported positive for B lymphocyte, but flow 
      cytometry crossmatch (FCXM) was reported negative for both B and T lymphocytes. 
      Luminex-SAB (single antigen bead) did not identify any donor specific antibodies 
      (DSA). He never had a blood transfusion. The positive CDC-crossmatch result is 
      not concordant with DSA status. These implausible results are due to underlying 
      lupus erythematosus, leading to false-positive B-lymphocyte crossmatch as a 
      result of binding immune complexes to Fc-receptors. False positive report of CDC 
      crossmatch can be caused by the underlying autoimmune diseases such as lupus 
      erythematosus, that may lead to inadvertent refusal of adequate kidney grafts. 
      Detailed study of DSA by molecular technique would prevent wrong exclusion of 
      such donors. Based on these investigations this patient is deemed to have 
      "standard immunological risk" for renal transplantation.
FAU - Althaf, Mohammed Mahdi
AU  - Althaf MM
AD  - Jack Pryor Renal Unit, Norfolk and Norwich University Hospital - NHS Foundation 
      Trust, Norwich NR4 7UY, United Kingdom.
FAU - El Kossi, Mohsen
AU  - El Kossi M
AD  - Faculty of Health and Science, University of Liverpool, Institute of Learning and 
      Teaching, School of Medicine, Liverpool L69 3GB, United Kingdom.
FAU - Jin, Jon Kim
AU  - Jin JK
AD  - Faculty of Health and Science, University of Liverpool, Institute of Learning and 
      Teaching, School of Medicine, Liverpool L69 3GB, United Kingdom.
FAU - Sharma, Ajay
AU  - Sharma A
AD  - Faculty of Health and Science, University of Liverpool, Institute of Learning and 
      Teaching, School of Medicine, Liverpool L69 3GB, United Kingdom.
FAU - Halawa, Ahmed Mostafa
AU  - Halawa AM
AD  - Faculty of Health and Science, University of Liverpool, Institute of Learning and 
      Teaching, School of Medicine, Liverpool L69 3GB, United Kingdom.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - World J Transplant
JT  - World journal of transplantation
JID - 101608356
PMC - PMC5743871
OTO - NOTNLM
OT  - Cytotoxic crossmatch
OT  - Flow cytometry crossmatch
OT  - Human leukocyte antigen null alleles
OT  - Human leukocyte antigen typing
OT  - Virtual crossmatch
COIS- Conflict-of-interest statement: There is no conflict of interest associated with 
      any of the senior author or other co-authors contributed their efforts in this 
      manuscript.
EDAT- 2018/01/10 06:00
MHDA- 2018/01/10 06:01
PMCR- 2017/12/24
CRDT- 2018/01/10 06:00
PHST- 2017/07/12 00:00 [received]
PHST- 2017/08/22 00:00 [revised]
PHST- 2017/10/17 00:00 [accepted]
PHST- 2018/01/10 06:00 [entrez]
PHST- 2018/01/10 06:00 [pubmed]
PHST- 2018/01/10 06:01 [medline]
PHST- 2017/12/24 00:00 [pmc-release]
AID - 10.5500/wjt.v7.i6.339 [doi]
PST - ppublish
SO  - World J Transplant. 2017 Dec 24;7(6):339-348. doi: 10.5500/wjt.v7.i6.339.