The first session of this year's workshop started with a series of very interesting presentations on crossmatches. The first paper was presented by Dr. Hauptfeld-Dolejsek, from the University of Alabama. In this report, the authors addressed the problem of the transplants performed after a negative crossmatch, but in which DSA can be found. In their experience, patients with antibody levels in a gray zone (1500 to 5000) are considered higher risk and deserve additional immunosuppression. Ten transplant cases were studied, and different protocols were tested. The paper presented by Dr. Gandhi dealt with the problem of the patients with a presumed positive (virtual) crossmatch, but with a real negative flow crossmatch. The authors presented a case in which the receptor had a significant amount of anti-donor antibodies, but all flow crossmatch performed was negative. After ruling out a series of possibilities to explain the discrepant results, they concluded that the antibody was probably against a denatured antigen of which the clinical significance is unknown.
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