Open AccessImplication of a positive virtual crossmatch with negative flow crossmatch: A mind-boggler
Author(s) -
Mohit Chowdhry,
Soma Agrawal,
Yogita Thakur,
Sandeep Guleria,
Vandana Sharma
Publication year - 2020
Publication title -
asian journal of transfusion science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.262
H-Index - 22
eISSN - 1998-3565
pISSN - 0973-6247
DOI - 10.4103/ajts.ajts_159_18
Subject(s) - medicine , human leukocyte antigen , antigen , antibody , epitope , immunology , complement dependent cytotoxicity , monoclonal antibody , antibody dependent cell mediated cytotoxicity
There are occasions when tests performed before considering a patient for transplant are ambiguous and require further workup. One such condition is the presence of a positive virtual crossmatch (VXm) (anti-human leukocyte antigen [HLA-A]*26: 01 antibody in this case) with a negative complement-dependent cytotoxicity, Luminex, and flow crossmatch. To ascertain the nature of the antibody, the beads used in single-antigen bead assay (SAB) were treated by acid to denature the antigens and retested with the control and test sample. The mean fluorescence intensities (MFIs) from the patient sera with acid-treated beads increased considerably as compared to the regularly untreated SAB indicating additional antigen epitopes become available by the denaturation process. The MFIs of the antibodies from that of the control sera were reduced to half on testing with the acid-treated SAB assay, indicating that HLA antigen HLA-A*26 was susceptible to acid treatment. Therefore, results of VXm should be interpreted with caution.