P020 : CAN LUMINEX DONOR SPECIFIC ANTIBODY CROSS MATCH BE A BETTER ALTERNATIVE OF COMPLEMENT DEPENDENT CYTOTOXICITY CROSS FOR RENAL TRANSPLANT CASES IN DEVELOPING COUNTRIES LIKE INDIA?

Aim Comparison of new Luminex cross match method with classical method of leukocyte cross match i.e. complement dependent cytotoxicity. Material & method Total 60 living related renal transplant cases were included in the study. All samples were tested for CDC as well as Luminex DSA cross match using donor lysate. The kits used were Gen Probe (Gen Probe transplantation diagnostics, Inc., 550 West Avenue, Stamford, CT 06902). In CDC cross match less than 20% cell lysis was considered negative & Luminex cross match mean fluorescence values (MFI) 1000 was considered negative for class I & II each. All the patients were followed up after 3 months. Result Out of 60 cases, 45 were negative for CDC as well as for Luminex DSA cross match class I & II. One case was found positive (MFI value was 16,165 & 13,219 for class I & II) for both & transplant not done. In 14 cases CDC was negative but Luminex crossmatch was positive. Out of 14, nine patients transplanted, no acute rejection reported. One patient died due to cardiac arrest. All 8 patients followed up after 3 months. In three patients creatinine was found abnormal between 3 and 4. When these patient’s pre transplant test records were checked, two of the patients were class II positive DSA with MFI of 7372 & 4317 and one patient was class I positive with MFI value 6322. Rest other cases found clinical good with normal serum creatinine value less than one. Conclusion CDC cross match found less sensitive than Luminex cross match. It came positive when Luminex MFI values were more than 10,000. Three out of 8 cases which were positive for either class I or II by Luminex cross match but negative CDC cross match have high creatinine value but no clinical sign of rejection within 3 months of transplant. Luminex DSA cross match using donor lysate more sensitive than CDC cross match, therefore could be a better & cost effective pre transplant testing in India where pre transplant tests are very limited and donor specific antibodies are not identified because of cost & resource constrain.