EVALUATION OF THE FLOW CYTOMETRIC CROSSMATCH

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Abstract
The flow cytometric crossmatch is a technique that is increasingly being used by clinical transplant laboratories. In this multicenter study by the British Society for Histocompatibility and Immunogenetics Flow Cytometry Group, a series of crossmatches were carried out to determine whether different centers obtained the same results when performing the same crossmatch. There was greater than 80% agreement among participating laboratories on the results of 34/54 tests. There was no clear agreement in the remaining 20 cases. Quantitative analysis, estimating the number of cell-bound fluorescein molecules, demonstrated that differences in the criteria used by each center to define a positive crossmatch were responsible for some of the discordant results. When applied, definition of positivity based on molecules of fluorescein increased concordance from 57.5% to 81.4%. These results suggest that a criterion for the interpretation of results based on quantitative analysis of bound antibody may be more reliable than methods in current routine use.