Immunopathology: positive crossmatch: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Immunopathology: positive crossmatch

Sample item

Before a kidney transplant, the recipient's serum is incubated with donor lymphocytes and complement, and the donor cells are lysed. The surgeon asks what the result predicts if the transplant goes ahead. What is the most likely outcome?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Hyperacute rejection from preformed anti-donor antibodies

A positive complement-dependent cytotoxicity crossmatch means the recipient already has antibodies against donor HLA. After grafting, these cause hyperacute rejection within minutes to hours, with endothelial damage, thrombosis and cortical necrosis, so the transplant is not done.

Option by option

  • A. Hyperacute rejection from preformed anti-donor antibodies (correct)

    Correct. Preformed antibodies bind graft endothelium immediately and cause hyperacute rejection.

  • B. Graft-versus-host disease

    GVHD arises when donor lymphocytes attack the host, usually after marrow transplant.

  • C. Chronic rejection with graft arteriosclerosis

    Chronic rejection develops over months to years.

  • D. Acute cellular rejection after one week

    Acute cellular rejection depends on T cells activated after grafting, not on a positive crossmatch.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, Hyperacute rejection from preformed anti-donor antibodies. A positive complement-dependent cytotoxicity crossmatch means the recipient already has antibodies against donor HLA.

Why is "Graft-versus-host disease" not the answer?

GVHD arises when donor lymphocytes attack the host, usually after marrow transplant.

Why is "Chronic rejection with graft arteriosclerosis" not the answer?

Chronic rejection develops over months to years.

Why is "Acute cellular rejection after one week" not the answer?

Acute cellular rejection depends on T cells activated after grafting, not on a positive crossmatch.

What concept does this question test?

It tests Immunopathology: positive crossmatch in Pathology. After grafting, these cause hyperacute rejection within minutes to hours, with endothelial damage, thrombosis and cortical necrosis, so the transplant is not done.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Immunopathology: positive crossmatch?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.