ST.

MICHAEL'S HOSPITAL
STAT CROSS MATCH DECISION ALGORITHM FOR DECEASED DONOR RENAL TRANSPLANT 2014-05-05

ANY PRA:
HAS THE RECIPIENT HAD A
Living Donor Graft
SENSITIZING EVENT Survival.pdf
SINCE LAST
YES

SERUM DATE?

YES

STAT XM
(NO EXCEPTIONS)

BRING IN
BACKUP

YES

STAT XM**

Backup on
case-by-case basis

NO

ANY PRA:
DOES THE RECIPIEINT HAVE DP DSA?
AND/OR
WAS AN ALLELE SPECIFIC DSA
POSSIBLE BUT RULED OUT BY LAB?

NO

YES
<6

Is the cPRA >80%

NO
YES
Is the cPRA 1-80%

How many sera are registered at TGLN?

NO

Reconfirm: cPRA is 0% with

at least 2 sera tested, or 0%
with single serum <3 mo old

6 or more

YES

Routine
Priority XM

NO BACKUP

NO
STAT XM for any uncertainty

DOCTOR to obtain from TGLN coordinator

Date of last serum sample
Number of serum samples in TGLN
Are there DP DSA?
Was there a possible allele specific DSA assessed and ruled out by lab?
ON CALL NURSE to ASK RECIPIENT
Any recent sensitizing event? (transfusion, pregnancy, miscarriage)

**IF A TIME
SENSITIVE ISSUE FOR
STAT XM
Clinician should call
HLA lab director to
discuss safety of
omitting stat XM in a
sensitized p atient