Antibody Therapeutics as Interfering Agents in Flow Cytometry Crossmatch for Organ Transplantation

Michael L. Kueht, Laxmi Priya Dongur, Muhammad A. Mujtaba, Matthew F. Cusick

Research output: Contribution to journalArticlepeer-review


Donor–recipient matching is a highly individualized and complex component of solid organ transplantation. Flowcytometry crossmatching (FC-XM) is an integral step in the matching process that is used to detect pre-formed deleterious anti-donor immunoglobulin. Despite high sensitivity in detecting cell-bound immunoglobulin, FC-XM is not able to determine the source or function of immunoglobulins detected. Monoclonal antibody therapeutic agents used in a clinic can interfere with the interpretation of FC-XM. We combined data from the prospectively maintained Antibody Society database and Human Protein Atlas with a comprehensive literature review of PubMed to summarize known FC-XM-interfering antibody therapeutics and identify potential interferers. We identified eight unique FC-XM-interfering antibody therapeutics. Rituximab (anti-CD20) was the most-cited agent. Daratumuab (anti-CD38) was the newest reported agent. We identified 43 unreported antibody therapeutics that may interfere with FC-XM. As antibody therapeutic agents become more common, identifying and mitigating FC-XM interference will likely become an increased focus for transplant centers.

Original languageEnglish (US)
Article number1005
JournalJournal of Personalized Medicine
Issue number6
StatePublished - Jun 2023


  • HLA
  • cross match
  • flow cytometry
  • histocompatibility
  • monoclonal antibodies
  • personalized medicine
  • transplantation

ASJC Scopus subject areas

  • Medicine (miscellaneous)


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