21-P

Abstract

Aim The aim of this study was to establish whether the presence of DSA detected by Luminex based solid-phase assay (SPA) correlates with the cross-match results performed by complement-dependent cytotoxicity (CDC) in deceased donor kidney transplantation. Methods Between January 1, 2012 and December 31, 2012, lymphocytes from a total of 398 deceased donors were cross-matched by our laboratory. For each donor, sera from an average of 6.24 patients were selected for direct cross-matching by CDC, amounting to a total of 2,485 cross-matches. Pre-transplant sera were screened by CDC on HLA reference panel, and by LABScreen using HLA class I and class II antigen coated beads. Results Of the 2,485 patients cross-matched, 870 had DSA and should have been excluded as potential transplant recipients on this basis. However, 39.3% (342/870) of the DSA positive population showed no cytotoxic antibodies to the putative donor reflecting the non-Complement fixing nature of the antibodies detected by SPA and/or their low affinity for their target antigen. Since 60.7% (528/870) of patients with DSA showed positive CDC cross-matches, there was still a highly significant correlation (P Conclusions In this study, we have shown that 39.3% of patients with DSA would have been denied the transplant if it was solely based on the virtual cross-match result. Furthermore, there was no statistically significant difference between graft function at one year in patients with or without DSA.