Abstract
Positive anti-human leukocyte antigen (HLA) antibodies are considered a contraindication for cardiac transplantation in India, due to its negative impact on cardiac allograft survival and increased chances of rejection post-transplant. Single antigen bead (SAB) assay helps to further characterize these antibodies. Our case portrays India's first reported successful cardiac transplant utilizing a virtual crossmatch (VXM)-based approach in a patient with positive anti-HLA antibody screen and SAB assay. We propose that adopting such an approach, in select cases, in India is certainly feasible. This approach would lead to increasing the potential donor pool and mitigate the chances of post-transplant rejection. With increased demands, the SAB assay cost would reduce, further improving its cost-effectiveness.