CASE REPORT: Serial Cases of False-Positive Flow-Cytometry T Cell Crossmatch Associated With Anti–Blood Type Antibodies in Patients Undergoing ABO-Incompatible Kidney Transplantation
Open Access
- 10 March 2022
- journal article
- research article
- Published by Frontiers Media SA in Frontiers in Immunology
- Vol. 13, 862652
- https://doi.org/10.3389/fimmu.2022.862652
Abstract
Background: A positive flow-cytometry T cell crossmatch (FTXM) has important prognostic implications, even when the complement-dependent cytotoxicity crossmatch is negative. Recent studies have shown that ABO incompatibility is associated with positive FTXM, but the underlying mechanism remains poorly understood. Cases: In five ABO blood type O recipients of kidneys from wives with type B, FTXM was positive but complement-dependent cytotoxicity crossmatch was negative. Application of a solid-phase technique (LABScreen) revealed no case with antibodies to donor-specific human leukocyte antigen. After removal of type B antibodies from patient sera, FTXM was negative for all five patients. In one tested case, the eluate prepared from the donor’s T lymphocyte agglutinated only type B red blood cells, implying the existence of blood type B substances on donor T lymphocytes. Discussion: False-positive FTXM reflects blood type B substrates bound to T lymphocytes. Repeat FTXM after incubation with donor-type red blood cells (to adsorb anti-ABO antibodies) was negative. This phenomenon explains the discrepancy between FTXM and solid-phase bead assays. Demonstration of type B substances on donor T lymphocytes is necessary before absolute test validity is confirmed. Conclusion: False-positive FTXM may be associated with type B antibodies bound to T lymphocytes when a blood type O recipient receives tissue from a type B donor. This phenomenon explains the false-positive FTXM observed in the setting of ABO-incompatible kidney transplantation.Keywords
This publication has 13 references indexed in Scilit:
- The Clinical Importance of Flow Cytometry Crossmatch in the Context of CDC Crossmatch ResultsTransplantation Proceedings, 2010
- Norovirus and its histo-blood group antigen receptors: an answer to a historical puzzleTrends in Microbiology, 2005
- T‐cell flow‐cytometry crossmatch and long‐term renal graft survivalClinical Transplantation, 2004
- Clinical implications of flow cytometry crossmatch with T or B cells in living donor liver transplantationClinical Transplantation, 2001
- Determination of LewisFUT3gene mutations by PCR using sequence-specific primers enables efficient genotyping of clinical samplesHuman Mutation, 2001
- Lewis and secretor gene dosages affect CA19-9 and DU-PAN-2 serum levels in normal individuals and colorectal cancer patients.1998
- Cytotoxicity of a non-HLA serum towards lymphocytes from blood group B, Lewis negative and ABH secretor individuals.1983
- Lymphocytotoxic definition of combined ABH and Lewis antigens and their transfer from Sera to lymphocytesHuman Immunology, 1980
- ABH and Lewis antigens on lymphocytes: screening of pregnant women's sera with the B-cell cytotoxicity test.1979
- EVIDENCE THAT BLOOD GROUP A ANTIGEN ON LYMPHOCYTES IS DERIVED FROM THE PLASMAInternational Journal of Immunogenetics, 1978