A potential living kidney donor has a positive complement-dependent lymphocytotoxicity crossmatch against the intended recipient. What does this finding indicate and what is the usual consequence?

• A Donor-specific anti-HLA antibodies are present; transplantation is contraindicated due to hyperacute rejection risk ✓
• B Recipient T-cell function is impaired; transplantation may proceed safely
• C ABO blood group mismatch is present; desensitisation is mandatory
• D It reflects laboratory error alone; repeat testing always becomes negative

Explanation

The complement-dependent cytotoxicity crossmatch mixes recipient serum with donor lymphocytes; donor-specific anti-HLA antibodies bind and activate complement, lysing the donor cells. A positive T-cell crossmatch predicts hyperacute rejection mediated by preformed antibodies, endothelial injury and intravascular thrombosis, so transplantation across it is generally contraindicated unless highly specialised desensitisation protocols are available. It tests HLA antibodies, not blood group compatibility.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.