Flow cytometric analysis of antidonor-specific antibodies in liver tranplant

THE PRESENCE of antidonor specific antibodies after renal allograft is implicated in graft rejection and is subsequent loss. The flow cytometric crossmatch (FXCM) assay is the most sensitive method for detecting these antibodies. Generally, this assay is used not only to detect low levels of antidonor antibodies but also to monitor a specific humoral response directed against donor antigens and the isotype of these antibodies after transplant.' Not all the antibodies occuring after after kidney transplant may play a negative role on graft outcome. In fact, some investigators have found that antidonor specific antibodies of anti-immunoglobulin A (IgA) isotype are strongly associated with long-term kidney transplant survival. The hepatic allograft is more resistent than other solid organs to mediated-antibody rejection, therefore, the liver allograft may be successfully performed with positive pretransplant crossmatch. This privileged nature of liver may depend on its ability to absorb preoperative antibodies and to be regenerated after damage. However, an increasing number of centers have reported poor graft outcome when antidonor cytotoxic antibodies are present before transplant.' T6 We introduced as routine the FXCM assay after every liver transplant in our center to identify the recipients with antidonor specific antibodies (antiDS Abs), understand their clinical relevance on graft rejection, and verify if IgA antiDS Abs are correlated with a successful graft outcome.