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What Does The Crossmatch Test Report Indicate?
Question: Dear Doctor, Good Morning. This is regarding my wife's kidney transplant. Patient's age - 40Years, Donor's Age - 37Years. All the tests are fine. But the Crossmatch reports say. CDC (T & B Cells Negative), Igm antibodies -negative. DSA (Class 1 - Negative, Class 2 - Weak Positive), PRA (Class 1 - Weak Positive, Class 2 - Moderate Positive). Just wanted to know if we can go ahead for transplant with this report?
Brief Answer:
Taking a risk.
Detailed Answer:
Hello XXXXXXX and welcome to HCM.
As an Urologist and kidney transplant surgeon, I can understand your concern.
You should mention duration, your wife's been on dialysis.
Also, what's the cause for kidney failure ( CKD ).
Is she a diabetic and what other treatment, she's undergoing.
Now, PRA is more important than the DSA.
PRA being positive in class 1 and 2, increases the chance of a rejection.
This is best discussed with your nephrologist.
DSA being weak positive, implies that donor vessels, may show some abnormality, increasing risk.
Decision must be taken, discussing these aspects in mind.
Wishing your wife well.
Dr. XXXXXXX J. MANGAT.
Taking a risk.
Detailed Answer:
Hello XXXXXXX and welcome to HCM.
As an Urologist and kidney transplant surgeon, I can understand your concern.
You should mention duration, your wife's been on dialysis.
Also, what's the cause for kidney failure ( CKD ).
Is she a diabetic and what other treatment, she's undergoing.
Now, PRA is more important than the DSA.
PRA being positive in class 1 and 2, increases the chance of a rejection.
This is best discussed with your nephrologist.
DSA being weak positive, implies that donor vessels, may show some abnormality, increasing risk.
Decision must be taken, discussing these aspects in mind.
Wishing your wife well.
Dr. XXXXXXX J. MANGAT.
Above answer was peer-reviewed by :
Dr. REMY KOSHY
Thank you doctor for reply.
Last month DSA class 2 was moderate positive (class 1 negative both times), PRA was moderate to strong positive. But now DSA class 2 is weak positive and PRA is weak to moderate positive. As per transplant nephrologist, it is showing decreasing trend of antibodies...so it's better to wait for a month or so for antibodies to settle and it may become normal ?.
Also as per them PRA is patient antibodies and has nothing to do with donor...so changing donor will not change PRA values ?
My wife doesn't have diabetes or BP problem. Once she got severe urinary tract infection and her BP shot up during delivery of our son around 5 years back but came to normal after 6 months.
She is on dialysis for the last one and half years thrice a week.
Last month DSA class 2 was moderate positive (class 1 negative both times), PRA was moderate to strong positive. But now DSA class 2 is weak positive and PRA is weak to moderate positive. As per transplant nephrologist, it is showing decreasing trend of antibodies...so it's better to wait for a month or so for antibodies to settle and it may become normal ?.
Also as per them PRA is patient antibodies and has nothing to do with donor...so changing donor will not change PRA values ?
My wife doesn't have diabetes or BP problem. Once she got severe urinary tract infection and her BP shot up during delivery of our son around 5 years back but came to normal after 6 months.
She is on dialysis for the last one and half years thrice a week.
Brief Answer:
Wait for ĎSA and PRA levels to minimize.
Detailed Answer:
Hi XXXXXXX
Among the 3 tests for compatibility of donor and recipient are :
1.blood group.
2. PRA.(panel reactive antibodies)
3. DSA.(Donor specific antibodies).
Among these 3, DSA,or cross match, is the single most important test.
Donor specific antibodies should be negative, for successful transplant.
A positive PRA of recipient, may be lowered by doing plasmapheresis.
High B.P.can be treated with medicines and controlled.
Wishing her well.
Dr. XXXXXXX J. MANGAT.
Wait for ĎSA and PRA levels to minimize.
Detailed Answer:
Hi XXXXXXX
Among the 3 tests for compatibility of donor and recipient are :
1.blood group.
2. PRA.(panel reactive antibodies)
3. DSA.(Donor specific antibodies).
Among these 3, DSA,or cross match, is the single most important test.
Donor specific antibodies should be negative, for successful transplant.
A positive PRA of recipient, may be lowered by doing plasmapheresis.
High B.P.can be treated with medicines and controlled.
Wishing her well.
Dr. XXXXXXX J. MANGAT.
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. REMY KOSHY
Answered by
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