ASHI Governance 

Standards for Histocompatibility Testing
(4/98) Copyright © 1995 - 2002 American Society for Histocompatibility and Immunogenetics. All rights reserved.

Section J - Non-Renal Organ Transplantation

J1.000 In cases when patients are at high risk for allograft rejection (e.g., patients with histories of allograft rejection, patients with high levels of preformed class I HLA antibodies), donors and recipients should be typed for HLA-A, B and DR antigens whenever possible.

J2.000 Patients at high risk for allograft rejection should be screened whenever possible for the presence of anti-HLA-A or B lymphocytotoxic antibodies, and for autoreactive antibodies.

J3.000 Crossmatching. See Section I3.000.

J3.100 Sera from patients at high risk for allograft rejection should be prospectively crossmatched whenever possible. Techniques with increased sensitivity (see I3.130) must be used. Crossmatch results should be available prior to transplantation of a presensitized patient.

J3.200 Final crossmatches performed prior to transplantation should utilize a recipient serum sample collected within the past 48 hours before transplant if the recipient has Class I lymphocytotoxic antibodies (determined by the laboratory’s established criteria for defining positive reactivity of recipient sera against donor’s unseparated cells or enriched T cells) or has had a recent sensitizing event (see I3.300). Otherwise, a serum collected within seven days should be used.

J3.300 If the patient receives a blood transfusion, has an allograft that is rejected or removed, or experiences any other potentially sensitizing event, a serum sample obtained at least 14 days post-sensitization should be used in the final crossmatch.

J3.400 Whenever possible, tissues for recipients at high risk for allograft rejection should come from crossmatch-negative donors (i.e., crossmatch with unseparated lymphocytes or enriched T-cells is less than 20% above background).