HLA antibody testing part 24

Donor-specific HLA antibody with a positive crossmatch:

Is forewarning always enough?

A positive crossmatch with solid-phase evidence of HLA donor-specific HLA antibody is associated with worse short and long-term allograft outcomes; conversely, in the absence of HLA donor-specific HLA antigen, a positive crossmatch may not correlate as strongly with outcomes. Identification of pretransplant donor-specific HLA antigen in living and deceased donation offers on opportunity to lower antibody levels through  desensitization and permit transplant; however, long term outcomes are variables.