Allografting patients with human leukocyte antigens (HLA) which are recognized by preformed antibodies constitutes the main cause for hyper-acute or acute rejections. In order to select recipients without these donor-specific antibodies, the complement-dependent cytotoxicity crossmatch (CDC-CM) assay was developed as a standard procedure about forty years ago. The negative outcome of pretranspl...

537 determined by correlating the recipient's serum reactivity against the T and B lymphocyte and monocyte populations as well as the use of HLA-specific monoclonal blocking antibodies. Thus, a procedure is now available for better prediction of graft survival in the recipient. The usefulness of this new procedure is particularly important in patients with high levels of sensi-tization. Investi...

B ILE duct complications continue to be a significant cause of bile morbidity after orthotopic liver transplantation, with an incidence of 7% to 34% of patients. 1•2 Bile of duct obstruction, usually due to strictures, biliary leakage, and/or cholangitis, accounts for the majority of these complications. In contrast. although low incidence of chronic rejection has been reported under FK 506-bas...

A successful transplantation, across a positive crossmatch barrier, is one of the most persistent long-standing problems in the field of kidney transplant medicine. The aim of this study was to describe seven consecutive living renal transplantations in recipients with positive crossmatch for donors or positive for donor specific antibodies (DSAs). A preconditioning regimen including plasmapher...

Thirty-eight sequentially placed liver and kidney allografts were evaluated with respect to patient and graft survival, and the influence of preformed lymphocytotoxic antibodies was analysed. The results suggest that the survival rate of combined liver and kidney transplantation is similar to the survival rate of liver transplantation alone. Sequentially placed kidney allografts may be protecte...

191 January 2015 B LOOD transfusion is the most frequent procedure performed during hospital admissions1 and many transfusions are administered in the perioperative period, often on a time-sensitive basis. In this clinical commentary, key points related to pretransfusion testing are reviewed with an emphasis on the electronic crossmatch, as well as the use of uncrossmatched erythrocytes in situ...

Allosensitized children listed with a requirement for a negative prospective crossmatch have high mortality. Previously, we found that listing with the intent to accept the first suitable organ offer, regardless of the possibility of a positive crossmatch (TAKE strategy), results in a survival advantage from the time of listing compared to awaiting transplantation across a negative crossmatch (...

H EPATIC allografts are more resistant than other solid organs to antibody-mediated rejection, and human hepatic transplants can be successfully performed in the face of donor-specific lymphocytotoxic antibodies (positive crossmatch).1.2 However, we recently reported a significant decrease in patient and graft survival when a liver transplant was performed against a positive IgG lymphocytotoxic...

One of the major challenges in the current era of organ transplantation is to find suitable organs for highly sensitized patients. Different approaches have been successful in a proportion of the patients. Several organ exchange organizations are currently implementing an acceptable mismatch program similar to the one developed by Eurotransplant. The basis of such a program is the accurate defi...