Serum antibody analysis and donor-recipient crossmatching
Crossmatching is the most direct method for determining donor-specific antibody reactivity in patient serum. Crossmatching was always based on the lymphocytotoxicity technique, similar to serologic HLA typing, whereby donor lymphocytes are first incubated with patient serum, then, after addition of rabbit complement, lysis of lymphocytes is assessed by the uptake of an extravital dye. A positive crossmatch is a contraindication for organ transplantation, because of the risk for hyperacute rejection and the higher incidence of vascular rejection during the early post transplant period. This applies particularly to kidney and heart transplants; liver allografts are more resistant to antibody-mediated injury
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