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T‐cell flow‐cytometry crossmatch and long‐term renal graft survival
Author(s) -
Rebibou JM,
Carvalho Bittencourt M,
SaintHillier Y,
Chabod J,
Dupont I,
Bittard H,
Chalopin JM,
Hervé P,
Tiberghien P
Publication year - 2004
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2004.00226.x
Subject(s) - medicine , allotransplantation , kidney transplantation , flow cytometry , kidney , panel reactive antibody , histocompatibility testing , histocompatibility , transplantation , urology , immunology , human leukocyte antigen , antigen , gastroenterology
Flow cytometry crossmatch (FCXM) is a more sensitive technique than classical complement‐dependent cytotoxicity (CDC) for the detection of donor‐directed antibody before renal transplantation. Nevertheless, the role of FCXM in predicting long‐term survival of kidney grafts is still unclear. The purpose of our study was to evaluate the impact of a positive T‐cell FCXM (T‐FCXM) on long‐term kidney allografts outcome. Of the 184 consecutive kidney transplantations performed in our center between 1 January1991 and 15 November 1996 a FCXM, performed concurrently to the pre‐transplant CDCXM, was available for 170 patients. The CDCXM was negative in all recipients. Among these recipients, 12 (7.1%) had a positive T‐FCXM. These patients were not different from patients with a negative T‐FCXM for donor and recipient age, sex, frequency of second transplantation, number of human leukocyte antigen matches or mismatches. Frequency of immunized patients was higher in kidney recipients with a positive FCXM (58.3% vs. 24.7%; p = 0.02, chi‐square test). Survival analysis revealed that kidney graft outcome was better in negative T‐FCXM recipients (p = 0.03), while patient survival was not statistically different. Our results suggest that a positive pre‐transplant T‐FCXM despite a negative CDCXM is associated with an impaired long‐term graft survival in renal allotransplantation.