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Case Reports in Transplantation
Volume 2016, Article ID 4534898, 3 pages
http://dx.doi.org/10.1155/2016/4534898
Case Report

False Positive B-Cells Crossmatch after Prior Rituximab Exposure of the Kidney Donor

Department of Histocompatibility, Amiens University Medical Center, 80000 Amiens, France

Received 2 March 2016; Accepted 13 April 2016

Academic Editor: Gerald Schlaf

Copyright © 2016 Judith Desoutter et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Crossmatching is essential prior to kidney transplantation to confirm compatibility between the donor and the recipient, particularly to prevent acute antibody-mediated rejection. An unexpected positive crossmatch may be obtained in recipients with an autoimmune disease or preexisting antibodies not detected by single-antigen bead array due to complement interference or who have been previously treated by desensitization protocols such as rituximab, antithymocyte globulin, or intravenous immunoglobulins. We report donor and recipient investigations that revealed unexpected positive B-cells crossmatch, probably due to donor cells, as the donor had received rituximab therapy shortly before organ harvesting, in a context of severe idiopathic thrombocytopenic purpura. We consequently detected unexpected Class II IgG complement-dependent cytotoxicity for all sera tested. Other laboratory investigations failed to elucidate the reasons for this recipient-related positivity.