A Positive Complement Dependent Cytotoxicity Immunoglobulin G Cross Match Due to Autoantibodies Developed After Hepatitis B Virus Infection with a Negative Luminex Bead Assays in a Renal Transplant Recipient
Abstract:
Human leucocyte antigen (HLA) alloimmunisation is considered a major histocompatibility barrier to successful organ transplantation, and a positive complement-dependent cytotoxicity crossmatch (CDC-XM) has historically been considered an absolute contraindication for kidney transplantation without desensitisation. Ongoing infections can also give rise to complement activating immunoglobulin (IgG) autoantibodies in blood, which can be detected by CDC-XM assay, but these autoantibodies do not confer additional risk to renal transplantation. Clinically inappropriate decisions, such as transplant denial, may be made if a false-positive CDC-XM is not interpreted correctly. We describe a patient who contracted hepatitis B virus infection just prior to his kidney transplant surgery from a living donor, which turned his previously negative CDC-XM result positive, resulting in the deferral of his transplant surgery. Proper correlation with solid phase (Luminex bead) assays helped him to undergo successful kidney transplantation without prior desensitisation.
