Korean J Transplant.  2022 Nov;36(Supple 1):S260. 10.4285/ATW2022.F-4030.

Virtual crossmatch versus complement-dependent cytotoxicity crossmatch in deceased kidney paired donations: a single-center experience from India

• Thakur V
• Sharma A
• Singh S
• Kenwar D
• Minz R
• Singh H
• Kumar M
• Bhushan B

• KMID: 2535477
• DOI: http://doi.org/10.4285/ATW2022.F-4030

Abstract

Background
High-resolution single antigen bead helps in identifying recipients' alloantibody profile in comparison with do-nors' histocompatibility antigens. Retrospective analysis of paired kidney donations using only virtual crossmatch (VXM; hu-man leukocyte antigen [HLA] only) versus actual crossmatch (using complement-dependent cytotoxicity crossmatch and HLA no flow cytometry) was done.
Methods
A total of 30 deceased donor kidney donations were carried out from August 2021 to mid-August 2022 at the Postgraduate Institute of Medical and Education Research; the initial 15 donations were carried out using actual crossmatch. Of the later 15 donor-recipients who underwent VXM, recipients with donor-specific antibody of mean fluorescence intensity >3,000 were excluded. All deceased donors were typed for high-resolution HLA-A, HLA-B, and HLA-DR.
Results
In the VXM group, 13 paired kidney donations (including five simultaneous pancreas and kidney transplants) and two dual kidney transplants were performed (a total of 28 transplants). Twelve graft biopsies (42.0%) were performed in the early postoperative period of which rejections were seen in six patients (21.0%), and five patients (17.8%) were given antirejection ther-apy. In the actual crossmatch group 15 deceased donors (four simultaneous pancreas and kidney transplants, one dual kidney transplants, one single kidney transplant, one pediatric paired kidney transplant), 10 graft biopsies (38.0%) were performed and seven (26.0%) were treated. The difference between the follow-up creatinine in two groups was not significant (VXM, 1.44±0.80; actual crossmatch, 1.60±1.72; P=0.66).
Conclusions
These results show excellent outcomes when only VXM is used in comparison to actual crossmatch, as it saves time, is cost-efficient, and avoids unnecessary recipients’ mobilization.