title: A quality control program for crossmatching procedures for solid organ transplantation. The participating laboratories of the Australasian and South Asian Tissue Typing Association.
abstract: The National Kidney Matching Scheme (NKMS) allows matching and allocation of donor organs throughout Australia. Sera from potential recipients are distributed to each interstate tissue typing laboratory on a monthly basis for crossmatching in the event of a cadaver donor. Therefore, it is essential there is consensus for results between these laboratories in order for donated organs to be allocated appropriately. A quality control program conducted under the auspices of ASEATTA was undertaken for (1) panel reactive antibody characterization; (2) routine T lymphocyte crossmatching; and (3) characterization of antibody isotype by DTT treatment. These aims were achieved by distribution of (1) six sera for the determination of PRA activity; (2) 20 scrambled trays including replicate dilutions of a strongly positive lymphocytotoxic serum, high titer monoclonal antibody and negative sera and; (3) 20 trays containing sera with IgG and/or IgM antibodies. These were then evaluated by each laboratory on a panel of T cells. There was concordance between laboratories for PRA levels and antibody characterization. However, there was considerable variation in crossmatch sensitivity and reproducibility, several laboratories had carryover and others could not detect weak IgM antibodies. These results demonstrate the utility and need for ongoing crossmatch exchange programs, particularly for laboratories participating in organ exchange programs.
authors.affiliation: Department of Clinical Immunology, Royal Perth Hospital, Perth, Australia.
authors.forename: A J
authors.initials: AJ
authors.lastname: Howden
authors.forename: D C
authors.initials: DC
authors.lastname: Sayer
authors.forename: G
authors.initials: G
authors.lastname: Bennett
authors.forename: L K
authors.initials: LK
authors.lastname: Smith
authors.forename: F T
authors.initials: FT
authors.lastname: Christiansen
mesh_terms: D004229:Dithiothreitol / Q000494:pharmacology; D005189:False Positive Reactions; D006680:HLA Antigens / Q000032:analysis / Q000097:blood; D006650:Histocompatibility Testing / Q000379:methods / Q000592:standards*; D006801:Humans; D007106:Immune Sera / Q000032:analysis; D016030:Kidney Transplantation / Q000592:standards*; D008297:Male; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D006680:HLA Antigens; D007106:Immune Sera; D004229:Dithiothreitol