Table 1.

Antibody-Detection Methods and Sensitivity.^*

Assay	Method
Cytotoxic cross-match	Donor lymphocytes, recipient serum, and complement are added together. If serum from the recipient contains donor-specific anti-HLA antibody at a level sufficient to kill recipient cells, it is called a positive cross-match. This requires a high level of antibody.
Flow-cytometric cross-match	Donor lymphocytes, recipient serum, and fluorescein-labeled antibodies against human IgG are mixed together. If recipient serum contains moderate levels of donor-specific anti-HLA antibody, it will be detected by flow cytometer and is called a positive flow-cytometric cross-match. Flow cytometry detects a moderate level of antibody.
Luminex antibody testing	Recipient serum is run through a column of beads coated with a wide range of polymorphic HLA molecules tagged with unique, identifying immunofluorescence. If recipient serum contains donor-specific anti-HLA antibody, even at a very low level, it can be detected by the Luminex assay.

^*The assays are listed in order from least sensitive (requires high levels of antibody for a positive result) to most sensitive (can detect low levels of antibody).