Technical and clinical aspects of the histocompatibility crossmatch assay in solid organ transplantation.

The presence of antibodies directed against human leukocyte antigens (HLA) expressed on donor cells is a significant risk factor for serious clinical complications after transplantation. The crossmatch assay is one of the most important tests available for the detection of donor-specific antibodies in potential allograft recipients. Early crossmatch methods utilized complement-dependent cytotoxicity, which is useful for detecting the donor-specific anti-HLA antibodies responsible for hyperacute allograft rejection but lacks adequate sensitivity.