Fallacies of a purely virtual platform: Virtual plus reality versus virtual reality - A case study

Transpl Immunol. 2023 Dec:81:101956. doi: 10.1016/j.trim.2023.101956. Epub 2023 Nov 10.

Abstract

Pretransplant immunological assessment of a transplant donor has evolved significantly over the last few decades with the advent of testing platforms with enhanced sensitivity and varying formats. The single antigen bead assay (SAB) assay, a virtual crossmatch (vXM) is used extensively and considered the gold standard for defining donor-specific antibodies (DSA) in many parts of the World. A country like India, is however challenged by the lack of adequate representation of locally frequent HLA alleles and hence in our institution, we continue to perform a physical crossmatch (pXM) on the Complement Dependent Cytotoxicity and flow cytometry platforms alongside the SAB. We report here a case report where the discrepancy between platforms of testing have raised certain pertinent questions in our interpretation of the vXM.

Keywords: Donor-specific antibodies; Flow cytometry crossmatch; Mean fluorescence intensity; Transplant workup; Virtual crossmatch.

Publication types

  • Case Reports

MeSH terms

  • Antibodies
  • Flow Cytometry
  • Graft Rejection
  • HLA Antigens*
  • Histocompatibility Testing
  • Humans
  • Isoantibodies
  • Kidney Transplantation*
  • Retrospective Studies
  • Tissue Donors

Substances

  • HLA Antigens
  • Antibodies
  • Isoantibodies