Monitoring HLA alloimmunization. Analysis of HLA alloantibodies in the serum of prospective transplant recipients.

The identification of serum HLA alloantibody in clinical transplantation can only be considered meaningful if the information derived from clinical tests can be used to predict crossmatch outcome. Drawing on the foundations and principles of blood transfusion medicine, this article presents a strategy for efficient, cost-effective patient HLA antibody monitoring that relies on a screening technique identical in sensitivity to the final donor crossmatch method. Application of this approach to the successful transplantation of highly immunized patients using HLA disparate cadaver renal allografts supports the contentions advanced within this article.