title: Falsely incompatible B-cell flow cytometry crossmatch after pronase treatment: a case report.
abstract: This report presents a falsely incompatible B cell crossmatch by flow cytometry in a lung transplant recipient. The patient was a 35-year-old Caucasian male with end-stage lung disease secondary to cystic fibrosis whose pretransplantation serologic workup did not disclose the presence of anti-HLA class II antibodies by single antigen bead testing. Unexpectedly, crossmatch of recipient sera with pronase-treated donor lymphocytes resulted in antibody binding to B cells only. The positive reactivity was reproducible in pronase-treated autologous B cells. Recipient sera did not react with nontreated donor or autologous lymphocytes. Herein, we describe our approach to this unexpected crossmatch result and consider the implications of false-positive crossmatch results on transplantation.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, Kentucky.
authors.forename: J D
authors.initials: JD
authors.lastname: Hart
authors.affiliation: Department of Microbiology, Immunology, and Molecular Genetics, University of Kentucky, Lexington, Kentucky. Electronic address: charles.lutz@uky.edu.
authors.forename: C T
authors.initials: CT
authors.lastname: Lutz
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, Kentucky.
authors.forename: C D
authors.initials: CD
authors.lastname: Jennings
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, Kentucky.
authors.forename: J R
authors.initials: JR
authors.lastname: May
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, Kentucky.
authors.forename: K
authors.initials: K
authors.lastname: Nelson
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, Kentucky.
authors.forename: S
authors.initials: S
authors.lastname: Jacobs
authors.affiliation: Division of Cardiothoracic Surgery, University of Kentucky, Lexington, Kentucky.
authors.forename: C W
authors.initials: CW
authors.lastname: Hoopes
mesh_terms: D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000032:analysis*; D000920:Antibody-Dependent Cell Cytotoxicity; D001402:B-Lymphocytes / Q000276:immunology; D001788:Blood Grouping and Crossmatching; D005188:False Negative Reactions; D005434:Flow Cytometry / Q000379:methods; D000949:Histocompatibility Antigens Class II / Q000276:immunology*; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D007518:Isoantibodies / Q000097:blood; D016040:Lung Transplantation; D008214:Lymphocytes / Q000276:immunology; D008297:Male; D011402:Pronase; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D000888:Antibodies, Anti-Idiotypic; D000949:Histocompatibility Antigens Class II; D007518:Isoantibodies; D011402:Pronase