Test Background This is a two-part test, performed by complement dependent cytotoxicity (CDC) and flow cytometry.
Clinical Indications HLA crossmatching tests recipients’ serum for the presence of anti-donor antibodies which may represent a risk or contraindication to transplantation, particularly in solid organ grafts. Preformed IgG, or occasionally IgM antibodies, in the recipient, directed against donor HLA antigens, are a cause of hyperacute or accelerated allograft rejection.
CDC detects IgG and IgM complement fixing antibodies that are likely to cause antibody-mediated rejection. FCXM does not rely on complement-dependent cytotoxicity and can therefore detect non-complement fixing IgG1 and IgG3 antibodies as well. It is significantly more sensitive than the CDC crossmatch and is of particular benefit prior to transplantation of sensitised recipients or recipients of second or subsequent allografts. It is important in these tests to provide very clear clinical details, including the relationship of the potential donor to the recipient.