CDC/HLA Cross Match Total (T+B) cells Profile

Blood

2 parameters

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No Fasting Required

Details

Checks compatibility between donor & recipient.

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Parameters

List of Tests
- CDC/HLA Cross Match Total (T+B) cells 5 ml serum 6 ml
- CDC/HLA Cross Match Total (T+B) cells EDTA Whole Blood

CDC/HLA Cross Match Total (T+B) cells Profile

Why is it done?
- The CDC/HLA Cross Match Total (T+B) cells profile is performed to assess compatibility between a donor's HLA (Human Leukocyte Antigen) and a potential transplant recipient's antibodies prior to organ or tissue transplantation
- Both serum and EDTA whole blood specimens detect HLA-reactive antibodies in the recipient's blood that could bind to and damage donor tissue, particularly affecting T cells and B cells
- The test is essential prior to kidney, heart, lung, liver, and pancreas transplantation to predict hyperacute rejection risk
- CDC/HLA Cross Match Total (T+B) cells 5 ml serum uses complement-dependent cytotoxicity (CDC) methodology to detect IgG and IgM antibodies against donor lymphocytes
- CDC/HLA Cross Match Total (T+B) cells EDTA Whole Blood provides an alternative specimen type that preserves cellular viability and allows assessment of both complement-dependent and antibody-dependent cellular cytotoxicity
- These tests work together as part of comprehensive HLA immunogenicity assessment to ensure optimal donor-recipient matching and minimize transplant rejection
- Indicated for recipients who are sensitized (previously exposed to foreign HLA antigens through transfusions, prior transplants, or pregnancy)
Normal Range
- CDC/HLA Cross Match Total (T+B) cells 5 ml serum - Normal (Negative): No cytotoxic reactivity detected; cell viability remains ≥80% in test wells with no statistically significant difference compared to negative control wells
- CDC/HLA Cross Match Total (T+B) cells 5 ml serum - Positive: ≥80% cell lysis or cytotoxic reactivity observed; indicates presence of HLA-reactive antibodies against donor cells
- CDC/HLA Cross Match Total (T+B) cells EDTA Whole Blood - Normal (Negative): No complement-mediated cytotoxicity detected; lymphocyte survival rate ≥80% with no significant antibody reactivity
- CDC/HLA Cross Match Total (T+B) cells EDTA Whole Blood - Positive: Demonstrates lymphocyte lysis ≥80%; indicates circulating donor-specific HLA antibodies in recipient's blood
- Borderline/Weakly Positive: 20-80% cell lysis; may require additional confirmation with flow cytometry crossmatch or single-antigen bead testing
- Both test formats result are reported as Binary (Negative/Positive) or Categorical (Negative/Weakly Positive/Positive)
Interpretation
- CDC/HLA Cross Match Total (T+B) cells 5 ml serum - Negative Result: Indicates acceptable immunological compatibility; recipient possesses no detectable complement-fixing HLA antibodies against donor lymphocytes; transplantation may proceed with lower risk of hyperacute rejection
- CDC/HLA Cross Match Total (T+B) cells 5 ml serum - Positive Result: Demonstrates HLA-reactive antibodies in recipient's serum that could bind to donor endothelium; indicates significant immunological incompatibility; associated with hyperacute and acute rejection risk; transplantation is generally contraindicated unless special circumstances exist (paired exchange, desensitization protocols)
- CDC/HLA Cross Match Total (T+B) cells EDTA Whole Blood - Negative Result: No donor-specific HLA antibodies capable of complement fixation detected in recipient's blood; confirms acceptable immunological match; safe to proceed with transplantation
- CDC/HLA Cross Match Total (T+B) cells EDTA Whole Blood - Positive Result: Indicates presence of complement-fixing donor-specific antibodies; high risk of hyperacute rejection where antibodies bind to vascular endothelium within minutes to hours post-transplant; typically contraindicates transplantation in standard protocols
- Weakly Positive Results: May represent low-affinity antibodies or non-complement-fixing antibodies; requires flow cytometric crossmatch confirmation and HLA single-antigen bead analysis to characterize specificity and clinical significance
- T cell reactivity vs B cell reactivity: Cross match results typically report T+B (total) lymphocytes; separate T and B cell analysis may help identify if antibodies are primarily anti-HLA Class I (affecting T cells) or anti-HLA Class II (affecting B cells)
- Factors affecting interpretation: Test sensitivity and specificity; presence of IgG vs IgM antibodies; complement levels in recipient serum; presence of non-HLA antibodies; recipient's immunosuppressive medication status at time of testing
- False positives: Can occur with lymphocytotoxic autoantibodies unrelated to HLA; contamination with bacteria or endotoxin; improper specimen handling; reagent issues
- False negatives: Potential with non-complement-fixing antibodies (particularly IgG with low-affinity); antibodies against non-HLA antigens; inadequate complement in testing system; low-titer antibodies below test sensitivity threshold
Associated Organs
- Primary organ system: Immune system (lymphocytes, HLA antigens, complement cascade); integrates with vascular endothelium of all transplanted organs
- Specific organs evaluated: Kidney - most common transplant; Heart - high risk for rejection; Lung - particularly susceptible to hyperacute rejection; Liver - relatively resistant but still requires assessment; Pancreas - requires careful HLA matching
- Hyperacute rejection: Occurs within minutes to hours if positive crossmatch; mediated by pre-existing recipient antibodies against donor HLA antigens on vascular endothelium; leads to complement activation, thrombosis, and immediate graft failure
- Acute rejection: Can develop within days to weeks; T cell-mediated and antibody-mediated mechanisms; positive crossmatch increases risk significantly
- Chronic rejection: Long-term consequence; progressive fibrosis and vascular intimal thickening; positive crossmatch contributes to accelerated chronic rejection
- Graft vasculopathy: Antibody-mediated endothelial injury; associated with positive crossmatch; leads to progressive coronary artery disease in cardiac transplants
- Systemic complications: Positive crossmatch results reflect patient's sensitization history; may indicate previous exposures through transfusions affecting multiple organ systems; implications for post-transplant immunosuppression requirements
Follow-up Tests
- Flow Cytometry Crossmatch (FCXM): Recommended when CDC crossmatch is positive or borderline; provides more sensitive detection of non-complement-fixing IgG antibodies; helps distinguish between complement-fixing and non-complement-fixing antibodies
- HLA Single-Antigen Bead (SAB) Testing: Essential follow-up for positive crossmatches; identifies specific HLA antigens against which recipient has antibodies; determines if antibodies are donor-specific or represent broader sensitization
- HLA Typing (High Resolution): Performs detailed donor and recipient HLA typing; identifies at risk HLA mismatches; helps predict cross-reactive antibody responses
- Panel Reactive Antibody (PRA) Testing: Assesses percentage of donor population to which recipient has antibodies; helps stratify sensitization level; useful for organ allocation priority
- Donor-Specific Antibody (DSA) Testing by Luminex: Confirms presence of antibodies specifically targeting donor HLA alleles; quantifies antibody levels (mean fluorescence intensity); predicts risk of antibody-mediated rejection
- Complement-Dependent Cytotoxicity (CDC) Repeat Testing: May be repeated with recipient on immunosuppressive therapy to assess improvement; or with additional desensitization protocols
- Post-Transplant Monitoring: Baseline histology if positive crossmatch accepted; regular biopsy protocols per institutional guidelines; serum creatinine and graft function monitoring; surveillance for acute rejection episodes
- Desensitization Protocol Monitoring: If positive crossmatch but proceeding with transplant; repeat CDC crossmatch; FCXM; SAB testing; DSA quantification at baseline and during desensitization therapy
- Anti-Donor Antibody Monitoring: Serial DSA testing post-transplant; helps predict chronic rejection; guides immunosuppressive therapy adjustments
- C1q Assay: Identifies complement-fixing antibodies; provides additional risk stratification for positive crossmatches
Fasting Required?
- No fasting required for the CDC/HLA Cross Match Total (T+B) cells profile; this is an immunological test not affected by nutritional status or food intake
- CDC/HLA Cross Match Total (T+B) cells 5 ml serum specimen: Patient may eat and drink normally; no dietary restrictions; specimen can be collected at any time of day
- CDC/HLA Cross Match Total (T+B) cells EDTA Whole Blood specimen: No fasting requirements; standard phlebotomy protocols apply; patient should remain seated for 5 minutes before collection to ensure accurate hematocrit if needed
- Medications: No medications need to be withheld; immunosuppressive medications should be continued as prescribed; current medication list should be documented for interpretation purposes
- Specimen collection timing: Serum specimen collection in tubes without additives; allow 30 minutes for clotting; centrifuge at 1000-1500 G for 10 minutes at room temperature; separate serum into sterile aliquots for testing and storage
- EDTA whole blood handling: Draw into EDTA (purple-top) vacutainer tube; gently invert 5-8 times to ensure mixing with anticoagulant; do not shake vigorously; keep at room temperature; process within 24 hours of collection for optimal cell viability
- Storage: Serum can be refrigerated at 2-8°C for up to 7 days or frozen at -20°C for longer storage; EDTA whole blood should not be frozen; maintain at room temperature or 4°C; process promptly for best results
- Patient preparation: Arrive at phlebotomy site; ensure adequate hydration (beneficial for blood draw); provide complete demographic information; communicate any recent transfusions, pregnancies, or prior transplants as this affects test interpretation
- Timing considerations: Test should be performed as close as possible to planned transplant date (typically within 1-7 days); living donor crossmatches may be scheduled in advance; deceased donor crossmatches performed urgently
- Special considerations: Patients on dialysis can be tested regardless of dialysis schedule; immunosuppressive medications do not require adjustment; patients should maintain normal daily activities; no activity restrictions after specimen collection

How our test process works!