Pre-formed antibodies increase the chances of immunological failure of the allograft by causing positive crossmatches and, thereby, result in the exclusion of donors.
[4] For patients with pre-formed DSA, successful transplantation can still be possible by employing strategies such as desensitisation, paired exchange and acceptable mismatching.
Similarly, false negative results are possible as this is purely complement dependent that requires higher antibody titres to be activated.
[9] Patel and Terasaki[2] in 1969 demonstrated the efficacy of complement-dependent lymphocytotoxic cross-match in defining immunologic risk in renal transplantation.
In recent years, techniques for detection of HLA antibodies have become more sensitive with the introduction of solid-phase assays, including ELISA.