Mahendra Narain Mishra and Vandana Lal
Background: Since 2014 Luminex crossmatch (LXM) is being performed regularly in India for post-transplant management of renal allograft recipients. Aim This study was planned to evaluate the possible role of the LXM in the post-transplant setting for the detection and characterization of HLA-specific IgG antibodies and to correlate with allograft biopsy and renalfunction. Methods: A retrospective study was performed on 169 consecutive LXM performed at a single center to investigate suspected allograft dysfunction (n=147) and for monitoring DSA in normally functioning allografts (n=22). A total of 116 biopsies (including 11 repeats) and 40 panel reactive antibody (PRA) screen tests were performed. Results: Donor specific antibodies (DSA) were detected in 81 samples (47.9%): 7 recipients had HLA class I DSA alone, 56 had only HLA class II DSA and 18 recipients had both. First time biopsies were categorized as: negative for rejection (n=30), antibody mediated rejection (n=32), acute cellular rejection (n=23), chronic rejection (n=15) and dual morphology (n=5). LXM was positive in 44/75 biopsies with rejection and transiently raised in 11/30 recipients who showed no evidence of rejection. On the basis of the LXM results biopsywas not performed in 42 recipients who showed improved renal function 15 recipients with non-specific findings on first biopsy. Conclusion: The study suggests that LXM is useful and economically viable algorithm for the detection of antibodies in the post-transplant work up of renal allograft recipients in developing nations.