Figure 1225

Immunologic evaluation for living donor transplantation. Generally, transplantation donors and recipients must have compatible blood groups. Tissue typing is also carried out, and the degree of human leukocyte antigen (HLA) matching may be taken into account in selecting the best living donor when more than one donor is available. Just before transplantation, the recipient's serum is tested against donor cells to be certain no preformed antibodies are present in the recipient that may cause a hyperacute rejection. A positive cross-match (X-match) generally precludes transplantation from that donor. CDC—cell-dependent cytotoxicity. (From Kasiske and coworkers [1]; with permission.)

Donor-specific transfusions in recipients

First transplantation?

No y

Consider other donor

Consider DST

Negative X-match, flow cytometry, or antiglobulin?

X-match negative?

Transplantation

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