Recent evidence indicates conclusively that adequate serologic assessment of histocompatibility is a necessary prerequisite to successful organ transplantation. It is of primary importance that initial donor selection be based on the ABO blood groups of the donor and recipient. Incompatibilities associated with these antigens can lead to severe and acute graft rejection. Compatibility of the leukocyte antigens associated with the HL-A locus can result in a favorable outcome of the graft especially among sibling donors and recipients. The relevance of preformed antibodies to leukocyte antigens can not be overemphasized. These antibodies have been implicated in early acute rejection, and therefore, a thorough search for their presence must be included in any preoperative serologic testing. Finally, some form of direct compatibility test or cross match should be employed as the ultimate test.
Zmijewski CM, Fletcher JL. The Preoperative Assessment of Histocompatibility. Arch Intern Med. 1969;123(5):514–520. doi:10.1001/archinte.1969.00300150032005