The relationship between flow cytometer crossmatch results and subsequent rejection episodes in cadaver renal allograft recipients.
Flow cytometry (FC) T and B cell crossmatches were done retrospectively for 38 cadaver renal transplant recipients (29 first and 9 retransplants--minimum follow-up 12 months) using both current pretransplant serum and peak-reactive sera. An increase in median fluorescence intensity (channel shift) and/or an increase in the number of donor T and/or B cells binding antibody in test sera occurred in 23 cases. These 23 patients experienced a greater number of reversible rejection episodes as compared with patients with negative FC crossmatches (65% vs. 33%), P = 0.031. Graft outcome, however, was not different in the two groups. Thus, a positive FC crossmatch allows for the detection of subliminal levels of donor presensitization and is associated with a greater number of rejection episodes. A positive FC crossmatch is not predictive of ultimate graft loss.
Lazda
V A
VA
Department of Surgery, University of Illinois, Chicago 60680.
Pollak
R
R
Mozes
M F
MF
Jonasson
O
O
D001402:B-Lymphocytes; D005434:Flow Cytometry; D006084:Graft Rejection; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation; D013601:T-Lymphocytes; D013997:Time Factors; D014184:Transplantation, Homologous