Evaluation of lymphocyte crossmatch (CDCXM and Flow XM) test results before kidney transplantation

Abstract

Purpose: Detection of anti-HLA antibodies is crucial in pre-transplant immunological assessment to evaluate donor-recipient compatibility and prevent hyperacute rejection. This study aimed to evaluate lymphocyte crossmatch (XM) test results performed before kidney transplantation.
Materials and methods: Lymphocyte crossmatch tests conducted at the Tissue Typing Laboratory of Pamukkale University Hospital between February 2020 and February 2024 were retrospectively analyzed. CDCXM (Complement-Dependent Cytotoxicity Crossmatch) and flow cytometric crossmatch (FCXM) tests were performed. For CDCXM, T and B lymphocytes were separated and tested individually, with serial dilution and DTT treatment applied. FCXM used anti-CD3 for T lymphocytes, anti-CD19 and anti-IgG for B lymphocytes, analyzed on a 10-color, 3-laser flow cytometer (Navios EX-Beckman Coulter, Inc. USA).
Results: A total of 225 CDCXM test results, 105 of which were alive and 120 of which were cadaver, were included in the study. CDCXM T and FCXM T were negative in living donors, while CDCXM B and FCXM B positivity were 4.8% and 2.6%, respectively. CDCXM T and B positivity in cadaveric donors were 3.3% and 7.5%, respectively, and FCXM T and B positivity were 3.3% and 8.8%, respectively.
Conclusion: Lymphocyte crossmatch remains a reliable and classical method for pre-transplant immunological evaluation. It effectively detects donor-specific anti-HLA antibodies and contributes to the prevention of hyperacute rejection in kidney transplantation.

Keywords

• Kidney transplantation
• lymphocyte crossmatch
• CDC crossmatch
• flowcytometric crossmatch
• anti-HLA antibodies

Böbrek nakli öncesi yapılan lenfosit crossmatch (CDCXM ve Flow XM) test sonuçlarının değerlendirilmesi

Abstract

Amaç: Anti-HLA antikorlarının tespiti, donör-alıcı uyumunu değerlendirmek ve hiperakut reddi önlemek için nakil öncesi immünolojik değerlendirmede kritik öneme sahiptir. Bu çalışmada, böbrek nakli öncesinde yapılan lenfosit çapraz uyum (XM) testi sonuçlarının değerlendirilmesi amaçlanmıştır.
Gereç ve yöntem: Şubat 2020 ile Şubat 2024 tarihleri arasında Pamukkale Üniversitesi Hastanesi Doku Tipleme Laboratuvarı'nda gerçekleştirilen lenfosit çapraz uyum testleri retrospektif olarak analiz edilmiştir. CDCXM (Komplement Bağımlı Sitotoksisite Çapraz Uyum) ve akım sitometrik çapraz uyum (FCXM) testleri gerçekleştirilmiştir. CDCXM için T ve B lenfositleri ayrı ayrı ayrı test edilmiş, seri dilüsyon ve DTT uygulanmıştır. FCXM'de T lenfositleri için anti-CD3, B lenfositleri için anti-CD19 ve anti-IgG kullanılmış ve 10 renkli, 3 lazerli akım sitometresinde (Navios EX-Beckman Coulter, Inc. USA) analiz edilmiştir.
Bulgular: Çalışmaya 105’i canlı ve 120’si kadavrada olmak üzere toplam Toplam 225 CDCXM test sonucu dahil edilmiştir. Canlı donörlerde CDCXM T ve FCXM T negatif bulunurken, CDCXM B ve FCXM B pozitifliği sırasıyla %4,8 ve %2,6 idi. Kadavra donörlerde CDCXM T ve B pozitifliği sırasıyla %3,3 ve %7,5, FCXM T ve B pozitifliği ise sırasıyla %3,3 ve %8,8 idi.
Sonuç: Lenfosit çapraz eşleştirme, nakil öncesi immünolojik değerlendirme için güvenilir ve klasik bir yöntem olmaya devam etmektedir. Vericiye özgü anti-HLA antikorlarını etkili bir şekilde tespit eder ve böbrek naklinde hiperakut reddin önlenmesine katkıda bulunur.

Keywords

• Böbrek nakli
• lenfosit çapraz eşleştirme
• CDC çapraz eşleştirme
• flowsitometrik çapraz eşleştirme
• anti-HLA antikorları

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