Hart J D, Lutz C T, Jennings C D, May J R, Nelson K, Jacobs S, Hoopes C W
Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, Kentucky.
Department of Microbiology, Immunology, and Molecular Genetics, University of Kentucky, Lexington, Kentucky.
Transplant Proc. 2015 Apr;47(3):831-3. doi: 10.1016/j.transproceed.2014.12.022.
This report presents a falsely incompatible B cell crossmatch by flow cytometry in a lung transplant recipient. The patient was a 35-year-old Caucasian male with end-stage lung disease secondary to cystic fibrosis whose pretransplantation serologic workup did not disclose the presence of anti-HLA class II antibodies by single antigen bead testing. Unexpectedly, crossmatch of recipient sera with pronase-treated donor lymphocytes resulted in antibody binding to B cells only. The positive reactivity was reproducible in pronase-treated autologous B cells. Recipient sera did not react with nontreated donor or autologous lymphocytes. Herein, we describe our approach to this unexpected crossmatch result and consider the implications of false-positive crossmatch results on transplantation.
本报告介绍了一名肺移植受者通过流式细胞术检测出的假不相容B细胞交叉配型结果。该患者为一名35岁的白种男性，患有囊性纤维化继发的终末期肺病，其移植前血清学检查通过单抗原珠检测未发现抗HLA II类抗体。出乎意料的是，受者血清与经链霉蛋白酶处理的供者淋巴细胞进行交叉配型时，仅导致抗体与B细胞结合。在经链霉蛋白酶处理的自体B细胞中，这种阳性反应是可重复的。受者血清与未经处理的供者或自体淋巴细胞均无反应。在此，我们描述了针对这一意外交叉配型结果的处理方法，并考虑了假阳性交叉配型结果对移植的影响。
