DRw antigen matching and B-cell antibody crossmatching: their effect on clinical outcome of renal transplants.

In a series of 36 cadaver transplants, we have found that matching the DR antigens had greater value in predicting good transplant outcome than did matching the A and B antigens. A much larger series of transplants utilizing DR antigen matching will be necessary to confirm these promising results; however, it would appear that performed donor-specific BLC detected at room temperature have no relationship to subsequent transplant outcome. It is, however, important to differentiate them from weak HLA-A,B,C antibodies which have been proven to lead to accelerated rejection. We recommend that the clinical crossmatch include simultaneous B-cell-depleted and B-cell-enriched tests to avoid this problem.