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The Flow Cytometry Crossmatch (FCXM) is a crucial tool in kidney transplantation, as it also enables the measurement of low levels of anti\u2010HLA DSA antibodies. However, current methodologies for detecting these antibodies, however, are time\u2010consuming and require extensive reagents. In this study, we analyzed the performance of the Halifaster FCXM protocol in 133 consecutive living kidney donor pairs, correlating these results with single antigen\u2010based anti\u2010HLA DSA results. Anti\u2010HLA DSA was identified in 31 patients (23.3%). Both T and B lymphocyte FCXM assays demonstrated high sensitivity and specificity in detecting anti\u2010HLA DSA. Furthermore, a Tree model to determine the levels of anti\u2010HLA DSA to produce a flow crossmatch positivity, was developed offering an accuracy of 93% and 90% for T and B lymphocytes, respectively. Both approaches point to a thresh old of 1000\u20132000 MFI for T lymphocytes and 3000 MFI for B lymphocytes. Our findings indicate that the Halifaster protocol facilitates fast and efficient FCXM testing without compromising accuracy, marking a significant advancement in the field of kidney transplantation. The inclusion of HLA\u2010specific antibody analysis underscores the protocol's comprehensive approach to improving transplant outcomes.<\/jats:p>","DOI":"10.1111\/tan.15391","type":"journal-article","created":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T14:33:35Z","timestamp":1708353215000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluation of rapid optimized flow cytometry crossmatch (Halifaster) in living donor kidney transplantation"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8911-3380","authenticated-orcid":false,"given":"Luis","family":"Ramalhete","sequence":"first","affiliation":[{"name":"Blood and Transplantation Center of Lisbon Instituto Portugu\u00eas do Sangue e da Transplanta\u00e7\u00e3o  Lisboa Portugal"},{"name":"NOVA Medical School, Faculdade de Ci\u00eancias M\u00e9dicas Universidade NOVA de Lisboa  Lisbon Portugal"},{"name":"iNOVA4Health 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