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Comparison of tests

Comparison of tests
  Single-antigen bead testing Flow crossmatch CDC crossmatch
Timeframe in which test is used

Pretransplant risk assessment

Posttransplant monitoring
At time of transplant At time of transplant
Platform Bead-based Donor cells Donor cells
Class of antibodies detected IgG IgG IgG and IgM
Antigen reactivity (specificity) Anti-HLA

Anti-HLA

Non-HLA

Anti-HLA

Non-HLA
Benefits More consistent than cell-based assays Detects Ab that can bind to the donor cells Detects Ab that can bind donor cells and fix complement
Assay sensitivity Highest sensitivity High sensitivity Lowest sensitivity
Drawbacks Clinical significance of low-level Ab unclear False positive with poor-quality cells False positive with poor-quality cells
HLA: human leukocyte antigen; CDC: complement-dependent cytotoxicity; IgG: immunoglobulin G; IgM: immunoglobulin M; Ab: antibody.
Courtesy of Melissa Y Yeung, MD, FRCPC.
Graphic 120941 Version 1.0