Presse medicale (Paris, France : 1983) · 1997
[Which cross-match before organ transplantation in 1997?].
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Raffoux C, Bignon J D
Аннотация
GOALS: The objective of pre-transplantation cross-matching is to detect in the recipient's serum solely those anti-donor antibodies which could have a deleterious effect on the grafted organ. It is important to avoid refusing organs on the basis of recipient antibodies which do not imply a risk of rejection.
SEVERAL METHODS: In most laboratories cross-matching or compatibility tests made before organ transplantation are based on a complement-dependent microlymphocytotoxicity technique, sometimes sensitized with anti-human globulin serum, reactive against target T-cells. A positive results is reported if the reactions are week, but other methods are available.
CHOICE OF SERA FOR CMX: This is essential. Several sera must be used: the most positive sera, the last serum and the current sera if the patient has been transfused between the date of the last serum harvested and the CMX.
IMMUNOLOGICAL STATUS: There is wide agreement on the requirement for quality surveillance of the recipient's immunological status. This policy is the only way to effectively select sera to cross-match before transplantation, whatever the technique used, and thus improve transplantation outcome and reduce the number of rejections.
CASE BY CASE: These prerequisites hold for all organs, but especially so for renal (and/or pancreas) grafts. For heart or heart-lung transplantations, emergency procedures may be needed.
SEVERAL METHODS: In most laboratories cross-matching or compatibility tests made before organ transplantation are based on a complement-dependent microlymphocytotoxicity technique, sometimes sensitized with anti-human globulin serum, reactive against target T-cells. A positive results is reported if the reactions are week, but other methods are available.
CHOICE OF SERA FOR CMX: This is essential. Several sera must be used: the most positive sera, the last serum and the current sera if the patient has been transfused between the date of the last serum harvested and the CMX.
IMMUNOLOGICAL STATUS: There is wide agreement on the requirement for quality surveillance of the recipient's immunological status. This policy is the only way to effectively select sera to cross-match before transplantation, whatever the technique used, and thus improve transplantation outcome and reduce the number of rejections.
CASE BY CASE: These prerequisites hold for all organs, but especially so for renal (and/or pancreas) grafts. For heart or heart-lung transplantations, emergency procedures may be needed.