BSHI/BTS guidance on crossmatching before deceased donor kidney transplantation

S Peacock¹, D Briggs², M Barnardo³, R Battle⁴, P Brookes⁵, C Callaghan⁶, B Clark⁷, C Collins², S Day⁸, N Diaz Burlinson⁹, P Dunn¹⁰, R Fernando¹¹, S Fuggle¹², A Harmer¹³, D Kallon¹⁴, D Keegan¹⁵, T Key¹³, E Lawson¹⁶, S Lloyd¹⁷, J Martin¹⁸, J McCaughan¹⁸, D Middleton¹⁹, F Partheniou¹⁹, A Poles^{20

21}, T Rees¹⁷, D Sage²², E Santos-Nunez²³, O Shaw²⁴, M Willicombe²⁵, J Worthington⁹

Affiliations

¹ Tissue Typing Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
² H&I Laboratory, NHSBT Birmingham Vincent Drive, Birmingham, UK.
³ Clinical Transplant Immunology, Churchill Hospital, Oxford, UK.
⁴ H&I Laboratory, SNBTS, Edinburgh, UK.
⁵ H&I Laboratory, Harefield Hospital, Harefield, UK.
⁶ Department of Nephrology and Transplantation, Guy's Hospital, London, UK.
⁷ H&I Laboratory, Leeds Teaching Hospitals NHS Trust, UK.
⁸ H&I Laboratory, Southmead Hospital, Bristol, UK.
⁹ Transplantation Laboratory, Manchester Royal Infirmary, Manchester, UK.
¹⁰ Transplant Laboratory, Leicester General Hospital, Leicester, UK.
¹¹ H&I Laboratory, The Anthony Nolan Laboratories, Royal Free Hospital, UK.
¹² Organ Donation & Transplantation, NHSBT, Stoke Gifford, Bristol, UK.
¹³ H&I Laboratory, NHSBT Barnsley Centre, Barnsley, UK.
¹⁴ H & I Laboratory, Royal London Hospital, London, UK.
¹⁵ Department of H&I, Beaumont Hospital, Dublin, UK.
¹⁶ Organ Donation and Transplantation, NHSBT, Birmingham, UK.
¹⁷ Welsh Transplantation & Immunogenetics Laboratory, Cardiff, UK.
¹⁸ H&I Laboratory, Belfast Health and Social Care Trust, Belfast, UK.
¹⁹ H&I Laboratory, Liverpool Foundation Trust, Liverpool, UK.
²⁰ H&I Laboratory, University Hospitals Plymouth, Plymouth, UK.
²¹ H&I Laboratory, NHSBT Filton, Bristol, UK.
²² H&I Laboratory, NHSBT Tooting Centre, London, UK.
²³ H&I Laboratory, Imperial College Healthcare NHS Trust, London, UK.
²⁴ H&I Laboratory, Viapath, Guys & St Thomas, London, UK.
²⁵ Department of Immunology and Inflammation, Imperial College London, UK.

PMID: 34555264
PMCID: PMC9292213
DOI: 10.1111/iji.12558

Review

BSHI/BTS guidance on crossmatching before deceased donor kidney transplantation

S Peacock et al. Int J Immunogenet. 2022 Feb.

. 2022 Feb;49(1):22-29.

doi: 10.1111/iji.12558. Epub 2021 Sep 23.

Authors

Affiliations

¹ Tissue Typing Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
² H&I Laboratory, NHSBT Birmingham Vincent Drive, Birmingham, UK.
³ Clinical Transplant Immunology, Churchill Hospital, Oxford, UK.
⁴ H&I Laboratory, SNBTS, Edinburgh, UK.
⁵ H&I Laboratory, Harefield Hospital, Harefield, UK.
⁶ Department of Nephrology and Transplantation, Guy's Hospital, London, UK.
⁷ H&I Laboratory, Leeds Teaching Hospitals NHS Trust, UK.
⁸ H&I Laboratory, Southmead Hospital, Bristol, UK.
⁹ Transplantation Laboratory, Manchester Royal Infirmary, Manchester, UK.
¹⁰ Transplant Laboratory, Leicester General Hospital, Leicester, UK.
¹¹ H&I Laboratory, The Anthony Nolan Laboratories, Royal Free Hospital, UK.
¹² Organ Donation & Transplantation, NHSBT, Stoke Gifford, Bristol, UK.
¹³ H&I Laboratory, NHSBT Barnsley Centre, Barnsley, UK.
¹⁴ H & I Laboratory, Royal London Hospital, London, UK.
¹⁵ Department of H&I, Beaumont Hospital, Dublin, UK.
¹⁶ Organ Donation and Transplantation, NHSBT, Birmingham, UK.
¹⁷ Welsh Transplantation & Immunogenetics Laboratory, Cardiff, UK.
¹⁸ H&I Laboratory, Belfast Health and Social Care Trust, Belfast, UK.
¹⁹ H&I Laboratory, Liverpool Foundation Trust, Liverpool, UK.
²⁰ H&I Laboratory, University Hospitals Plymouth, Plymouth, UK.
²¹ H&I Laboratory, NHSBT Filton, Bristol, UK.
²² H&I Laboratory, NHSBT Tooting Centre, London, UK.
²³ H&I Laboratory, Imperial College Healthcare NHS Trust, London, UK.
²⁴ H&I Laboratory, Viapath, Guys & St Thomas, London, UK.
²⁵ Department of Immunology and Inflammation, Imperial College London, UK.

PMID: 34555264
PMCID: PMC9292213
DOI: 10.1111/iji.12558

Abstract

All UK H&I laboratories and transplant units operate under a single national kidney offering policy, but there have been variations in approach regarding when to undertake the pre-transplant crossmatch test. In order to minimize cold ischaemia times for deceased donor kidney transplantation we sought to find ways to be able to report a crossmatch result as early as possible in the donation process. A panel of experts in transplant surgery, nephrology, specialist nursing in organ donation and H&I (all relevant UK laboratories represented) assessed evidence and opinion concerning five factors that relate to the effectiveness of the crossmatch process, as follows: when the result should be ready for reporting; what level of donor HLA typing is needed; crossmatch sample type and availability; fairness and equity; risks and patient safety. Guidelines aimed at improving practice based on these issues are presented, and we expect that following these will allow H&I laboratories to contribute to reducing CIT in deceased donor kidney transplantation.

Keywords: HLA; antibodies; kidney transplantation; virtual crossmatching.

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Conflict of interest statement

All authors participated in the working group, contributed to these guidelines, and have read and approved the final manuscript. SP and DB prepared the following text.

References

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1. BSHI & BTS Guideline . The detection and characterisation of clinically relevant antibodies in allotransplantation. July (2015). https://bts.org.uk/wp‐content/uploads/2016/09/06_BTS_BSHI_Antibodies‐1.pdf

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BSHI/BTS guidance on crossmatching before deceased donor kidney transplantation

Affiliations

BSHI/BTS guidance on crossmatching before deceased donor kidney transplantation

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical

Research Materials