Acute Antibody-Mediated Rejection of Transplantation with Negative Prospective Crossmatch Results

  • Soumya Pandey
  • Terry HarvilleEmail author


  • This case illustrates there will always be additional factors present that can interfere with successful transplantation

  • When an unexpected acute/hyper acute rejection occurs, all data are reviewed and results of all donor specific antibodies (DSA) and fluorescence cytometric crossmatch (FCXM) are recollected, even if a particular DSA was elevated only once and many years ago

  • If there is a more suitable recipient available for the donor, then it might be reasonable to defer the donor to those who do not have DSA or positive FCXM, even if positive only in the remote past


Antibody-mediated rejection (AMR) Donor specific antibody (DSA) Fluorescence cytometric crossmatch (FCXM) 


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    Sullivan H, Gebel H, Bray R. Understanding solid-phase HLA antibody assays and the value of MFI. Hum Immunol. 2017;78(7–8):471–80.CrossRefGoogle Scholar
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    Schinstock C, Gandhi M, Stegall M. Interpreting anti-HLA antibody testing data: a practical guide for physicians. Transplantation. 2016;100(8):1619–28.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Pathology and Laboratory ServicesUniversity of Arkansas for Medical SciencesLittle RockUSA
  2. 2.Departments of Pathology and Laboratory Services, Pediatrics, and Internal MedicineUniversity of Arkansas for Medical SciencesLittle RockUSA

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