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Complement dependent cytotoxicity crossmatch (CDCXM) is has been a test to assess the compatibility of an organ donor and recipient since 1969. A positive CDCXM would mean the presence of donor specific HLA antibodies in the recipient’s serum which could lead to hyperacute rejection or accelerated rejections of the allograft. Due to the subjectivity and the crudeness of the test, over years this test has undergone modifications to improve the sensitivity and specificity. In the last two decades, test-sensitive platforms which use non cell based tests have evolved which are more sensitive and specific. This chapter will discuss the CDCXM in detail and elucidate the combined use of all the available platforms and provide comparison of all available tests. Lastly clinical cases have been added which will help clinicians understand the application of these tests and effectively immune stratify a patient to improve outcomes and plan immunosuppression.

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A Persistent CDC Positive Cross-Match in a Patient Awaiting Transplant: Variations of the CDC and Comparisons Across Platforms

  • 章节

  • 发表日期：

    2025年

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  • Shruti Tapiawala,
  • Dolly Daniel,
  • Suchita Jogale,
  • Edwin Fernado,
  • Sree Bhushan Raju

摘要

Complement dependent cytotoxicity crossmatch (CDCXM) is has been a test to assess the compatibility of an organ donor and recipient since 1969. A positive CDCXM would mean the presence of donor specific HLA antibodies in the recipient’s serum which could lead to hyperacute rejection or accelerated rejections of the allograft. Due to the subjectivity and the crudeness of the test, over years this test has undergone modifications to improve the sensitivity and specificity. In the last two decades, test-sensitive platforms which use non cell based tests have evolved which are more sensitive and specific. This chapter will discuss the CDCXM in detail and elucidate the combined use of all the available platforms and provide comparison of all available tests. Lastly clinical cases have been added which will help clinicians understand the application of these tests and effectively immune stratify a patient to improve outcomes and plan immunosuppression.