The crossmatch policy of the transplantation center influences graft survival in cadaver kidney transplantation.

The outcome of cadaver kidney transplantation is influenced by several independent parameters including the center effect. In this parameter is included patient management in the pre- and posttransplantation phases, as well as the policy of the transplantation center with respect to sensitized patients and crossmatching. It is generally accepted that sensitization influences the graft outcome but the complications of the crossmatch policy of the individual transplant centers have never been studied in a systematic way. Here, using the results from 24 transplantation centers, served by 22 tissue typing laboratories affiliated with Eurotransplant, we provide indirect evidence that the crossmatch policy of the transplant center has a significant influence on the graft outcome. The use of historical sera for the decisive crossmatch is beneficial for graft survival in sensitized patients.