Successful liver transplantation from crossmatch-positive donors.

Abstract

We have published before that liver transplantation can be performed successfully in spite of positive anti-donor crossmatches detected with the standard cytotoxicity test.1,2 These so-called positive crossmatch cases were compiled before the classification of the responsible antibodies3 was possible. In the present study, ten previously reported recipients whose sera contained anti-donor cytotoxic antibodies were reviewed. The quantity and type of antibodies in the recipient sera were determined from their reactions to a panel of lymphocyte donors. From the results, an educated guess became possible as to whether the previous positive crossmatches against the organ donors were caused by warm anti-T antibodies or by less dangerous varieties. Finally, a fresh transplant was performed in a patient whose preoperative serum contained warm anti-T-lymphocyte antibodies that reacted with heavy killing against the liver donor.