Rp. Pelletier et al., Comparison of crossmatch results obtained by ELISA, flow cytometry, and conventional methodologies, HUMAN IMMUN, 60(9), 1999, pp. 855-861
The complement-dependent lymphocytotoxicity crossmatch (CXM) is the present
ly accepted standard for detection of donor-reactive alloantibodies in tran
splant patients. However, the newer flow cytometric (FXM) and ELISA (EXM) c
rossmatch technologies are increasingly used as substitutes for the CXM. We
have compared the sensitivity and reproducibility of FXM vs. EXM and, in g
eneral, find them to be quite similar. However, when we compared the agreem
ent of FXM vs. EXM in 112 donor/recipient combinations, we found that they
identified different subsets of donor-specific alloantibodies in about 35%
of the tests. When compared to the standard CXM method, the EXM correlated
much better than did the FXM, yielding a much lower rate of false positive
(2.5% vs. 8%) and false negative (7% vs. 18.5%) results. The reduction in t
ime required to obtain a result (3 h) and the cost of materials ($25/test)
was identical for the EXM and FXM. We conclude that the ELISA method for cr
ossmatching has advantages over the flow cytometric method as a substitute
for the present standard complement-dependent lymphocytotoxicity method. (C
) American Society for Histocompatibility and Immunogenetics, 1999. Publish
ed by Elsevier Science Inc.