In transplant immunology, which HLA matching criterion is MOST critical for preventing hyperacute rejection in kidney transplantation?
- A HLA-DR matching
- B Negative cross-match for pre-formed donor-specific antibodies ✓
- C ABO blood group compatibility
- D HLA-A and HLA-B antigen matching
Correct answer: B. Negative cross-match for pre-formed donor-specific antibodies
Explanation
Hyperacute rejection is mediated by pre-formed donor-specific antibodies (DSAs) that bind donor endothelial HLA antigens, activating complement and causing thrombosis within minutes to hours. A negative cross-match test (mixing recipient serum with donor lymphocytes) is mandatory before transplantation to rule out pre-formed DSAs. ABO compatibility prevents a similar antibody-mediated hyperacute process. HLA-DR matching is important for chronic rejection and long-term graft survival but not for preventing hyperacute rejection.
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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