Highly sensitised children have markedly reduced chances of receiving a successful deceased donor renal transplant, increased risk of rejection, and decreased graft survival. There is limited experience with the long-term followup of children who have undergone desensitization. Following 2 failed transplants, our patient was highly sensitised. She had some immunological response to intravenous ...

More than one-third of patients on waiting lists for kidney transplant are sensitized. Most have previously formed donor-specific and non-donor-specific serum antibodies and/or positive crossmatch by complement-dependent cytotoxity and/or flow cytometry. Two categories of alloantibodies include antibodies against major histocompatibility complex human leukocyte antigen class 1 and class 2 and a...

In 1969, Patel and Terasaki [1] reported that a positive cytotoxic crossmatch between donor lymphocytes and recipient serum was associated with early or immediate graft loss. From this seminal finding it quickly became apparent that the clinically relevant antibodies in a positive lymphocyte crossmatch were those directed against antigens encoded by the human major histocompatibility complex (M...

Blood groups A, B, and O were described by Landsteiner in 1901 and the serological crossmatch between the blood donor and the recipient, as a means of preventing ABO incompatibility, was first described by Ottenberg in 1908. In 1941, Rh antibodies were found to be the cause of haemolytic disease of the newborn. The earliest detected forms of anti-D antibodies were very strong and found by salin...

Six hundred sixty-seven first, second, and third orthotopic liver allografts in 520 patients were reviewed to determine the effect of recipient panel-reactive antibody (PRA) and donor-recipient antibody crossmatch on 2-year patient and liver allograft survival rates. Neither a high panel-reactive antibody nor a positive crossmatch for donor-specific preformed antIbody was associated with decrea...

Transfusion of crossmatch-incompatible red blood cells (RBCs) can result in antibody-mediated hemolysis. However, in some patients, crossmatch-incompatible RBCs lose the incompatible antigen from their surface, and then circulate normally ("antigen loss"). Although antigen loss has been reported in the settings of autoimmune hemolytic anemia and transfusion of crossmatch-incompatible RBCs, mech...

Ongoing technological developments in antibody detection and characterisation allowing relative quantitation of HLA-specific antibody levels, combined with crossmatch results, now allow a graded assessment of patient potential donor immunological risk for allotransplantation, rather than a simple 'positive' or 'negative' categorization of crossmatch results. These developments have driven a tho...