VIRTUAL CROSSMATCH DETERMINES DONOR-RECIPIENT PAIRS FOR HEART TRANSPLANTATION

摘要

Introduction: Solid phase immunoassays allow identification of unacceptable HLA antigens for the prediction of compatible donor/recipient pairs. This process is referred to as virtual crossmatch (vXM). Since 2001, we have used solid phase immunoassays to define the specificity of HLA antibodies for our sensitized patients on the kidney, heart, or lung transplant waitlists and utilized the vXM to select donors for heart, lung transplantations. The aim of the study was to evaluate the accuracy of the vXM used for donor selection for sensitized heart recipients. Patients and Methods: Patients who received heart transplants between January 2005 and September 2009 were included in this study. Sensitization was defined by presence of positive flow PRA and defined specificity of HLA antibodies. Solid phase immunoassays were used to screen for HLA antibodies and define unacceptable HLA antigens for each sensitized patient. Utilizing the principle of vXM, only donors without unacceptable HLA antigens were used for non-emergent sensitized patients. For sensitized patients needing emergent transplant, anti-HLA antibodies not detected at a dilution of 1:16 were considered low titer and were not considered for donor selection. All XMs were performed by flow cytometry since middle of 2005.