Auto-Crossmatch

CPT: 86825
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Test Details

Synonyms

  • Flow Crossmatch
  • HLA Crossmatch
  • T-Cell and B-Cell Crossmatch

Use

Detection of the presence of autoantibodies (HLA) in a solid organ recipient. T- and B-cell crossmatch detects the presence of anti-Class I/Class II HLA antibodies in the patient.

Limitations

Although the primary antibodies that are detected by this assay are to HLA, other non-HLA specific antibodies could cause positive T- and/or B-cell crossmatch. This test only demonstrates antibodies that recognize donor antigens and cannot distinguish clinical relevant antibodies (eg, complement binding ability) from nonclinical antibodies. This assay only detects the presence of IgG antidonor antibodies and does not detect IgM or other immunoglobulin subclasses.

Methodology

Presence of antibody bound to human lymphocytes detected by immunofluorescence and flow cytometry

Specimen Requirements

Specimen

Donor sample: Whole blood; Recipient sample: Serum

Volume

Blood sample: 12 mL; Serum sample: 2 mL

Minimum Volume

Blood sample: 8 mL; Serum sample: 2 mL

Container

Donor sample: Yellow-top (ACD) tube (solution A or B). Recipient sample: Red-top tube or gel-barrier tube

Patient Preparation

None

Storage Instructions

Maintain whole blood and serum at room temperature. Specimens should be analyzed within 72 hours of collection. Serum may be stored at 4°C for one week or at -20°C indefinitely.

Causes for Rejection

EDTA or heparin tube; hemolysis; clotted specimen; donor samples exceeding 72 hours

Clinical Information

Special Instructions

To schedule this test, you must telephone 800-533-1037, HLA customer service.

References

Bray RA. Flow cytometry in the transplant laboratory. Ann NY Acad Sci. 1993 Mar 20; 677:138-151. 8494203
Gebel HM, Bray RA, Nickerson P. Pre-transplant assessment of donor-reactive, HLA-specific antibodies in renal transplantation: Contraindication vs. risk. Am J Transpl. 2003 Dec; 3(12):1488-1500. 14629279
Graff RJ, Xiao H, Schnitzler MA, et al. The role of positive flow cytometry crossmatch in late renal allograft loss. Hum Immunol. 2009 Jul; 70(7):502-505. 19364513
Karpinski M, Rush D, Jeffery J, et al. Flow cytometric crossmatching in primary renal transplant recipients with a negative anti-human globulin enhanced cytotoxicity crossmatch. J Am Soc Nephrol. 2001 Dec; 12(12):2807-2814. 11729251
Organ Procurement and Transplantation Network/Health Resources and Services Administration/ US Department of Health and Human Services. Policy Management. Available at: http://optn.transplant.hrsa.gov/policiesAndBylaws/policies.asp. Accessed June 20, 2014.
Patel R, Terasaki PI. Significance of the positive crossmatch test in kidney transplantation. N Engl J Med. 1969 Apr 3; 280(14):735-739. 4886455
Tinckam, KJ. Basic Histocompatibility testing methods. In: Chandraker A, Sayegh MH, Singh AK, eds. Core Concepts in Renal Transplantation. Springer Publishing; 2012: chap 2.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
167145 Auto-Crossmatch by Flow 167186 AutoCrossmatch T-Cell(AUTCELL) 48409-7
167145 Auto-Crossmatch by Flow 167187 AutoCrossmatch B-Cell(AUBCELL) 48390-9

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The LOINC® codes are copyright © 1994-2017, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC® codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at https://loinc.org/license/. Additional information regarding LOINC® codes can be found at LOINC.org, including the LOINC Manual, which can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf