Journal of The Egyptian Society of Nephrology and Transplantation

REVIEW ARTICLE
Year
: 2017  |  Volume : 17  |  Issue : 4  |  Page : 107--114

Case-based review of cross-match techniques in kidney transplantation


Obadiah Moyo1, Ajay K Sharma2, Ahmed Halawa3 
1 Department of Nephrology, Chitungwiza Central Hospital, Harare, Zimbabwe
2 Royal Liverpool University Hospital, Liverpool, UK
3 Sheffield Teaching Hospitals, Sheffield Kidney Institute, University of Sheffield, Sheffield, UK

Correspondence Address:
Dr. Ahmed Halawa
Sheffield Teaching Hospital, Herries Road, Sheffield S5 7AU
UK

To avoid renal allograft rejection and loss, human leucocyte antigen compatibility and lymphocytotoxic cross-matching of renal donors against prospective renal allograft recipients are obligatory and fundamental steps in pretransplant evaluation. The complement-dependent cytotoxicity assay has been the mainstay technique for ascertaining the presence of donor-specific antibodies since the 1970s. Improvement in the performance of cross-matching has seen the introduction of more sensitive and specific techniques such as flow cytometry, and highly sensitive enzyme-linked immunosorbent assay, Luminex platforms and virtual cross-match. This review article is an in-depth comparison of the advantages and disadvantages of each of the cross-match techniques. We demonstrate the application of these techniques through a clinical case scenario. A step-by-step analysis and interpretation of cross-match modalities of varying levels of sensitivity and specificity is needed to arrive at a pragmatic decision, which will lead to better transplantation outcome. In some patients with immunologically complex issues, a spectrum of cross-match techniques may be required for a safe outcome of transplant.


How to cite this article:
Moyo O, Sharma AK, Halawa A. Case-based review of cross-match techniques in kidney transplantation.J Egypt Soc Nephrol Transplant 2017;17:107-114


How to cite this URL:
Moyo O, Sharma AK, Halawa A. Case-based review of cross-match techniques in kidney transplantation. J Egypt Soc Nephrol Transplant [serial online] 2017 [cited 2018 Feb 18 ];17:107-114
Available from: http://www.jesnt.eg.net/article.asp?issn=1110-9165;year=2017;volume=17;issue=4;spage=107;epage=114;aulast=Moyo;type=0