{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T07:44:15Z","timestamp":1792395855981,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HLA"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Virtual crossmatch (VXM) is increasingly used in deceased\u2010donor kidney allocation, raising questions about the added value of a physical crossmatch (PXM) when donor\u2010specific antibody (DSA) are absent. We applied our previously described flow cytometry\u2013based assay (FCtox), combining complement\u2010mediated cytotoxicity and IgG binding, across 3236 routine crossmatches performed between 2018 and 2024. All donor offers underwent VXM followed by prospective PXM. Among 704 patients, 95% of FCtox assays were performed in VXM\u2010 cases. FCtox positivity was uncommon in VXM\u2010 cases (9%), and overall concordance between VXM and FCtox was high (89%). Further analyses indicated that isolated FCtox abnormalities in VXM\u2010 cases primarily reflect patient\u2010specific background reactivity, including non\u2010HLA or IgM\u2010mediated effects. Among transplanted VXM\u2010 patients with FCtox positivity (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200912), no early antibody\u2010mediated rejection occurred. In VXM+ patients, DSA mean fluorescence intensity (MFI) values above 5000 were associated with increased likelihood of FCtox IgG positivity, although overlap between groups limited the ability of MFI alone to predict FCtox IgG reactivity. Overall, VXM reliably identified clinically meaningful immunologic risk, while FCtox added little value in VXM\u2010 candidates but remained useful in selected VXM+ or discordant scenarios. These findings support a VXM\u2010driven allocation strategy with selective rather than routine use of PXM.\n                  <\/jats:p>","DOI":"10.1111\/tan.70800","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T08:38:11Z","timestamp":1782808691000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Flow Cytometry Crossmatch With Combined Cytotoxicity and\n                    <scp>IgG<\/scp>\n                    Detection: Ten Years of Use in Deceased Donor Kidney Allocation"],"prefix":"10.1111","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9169-4155","authenticated-orcid":false,"given":"Mats","family":"Alheim","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Division of Clinical Immunology and Transfusion Medicine Karolinska University Hospital  Stockholm 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