Can we use dilution-titration studies to identify clinically relevant HLA antibody specificities?

These data suggest the presence of virtual crossmatch positive, low titer donor specific anti-human leukocyte antigen antibody (DSA) positive sera does not guarantee that real-time crossmatches will be positive. DSA that are present at an undiluted concentration but absent at a 1:8 or 1:16 dilution may not have to be considered unacceptable. This would allow potential recipients wider access to donor organs by reducing the number of listed unacceptable antigens. It also calls into question the use of virtual crossmatching, which may be disenfranchising minorities. Finally, evaluation of antibody concentration by dilution or titer may be clinically more useful than mean fluorescence intensity.