Renal allograft survival in patients with positive B cell crossmatch to their donor.
B cell crossmatches were performed at cold (4 C) and warm (22 C and 37 C) temperatures on 193 renal allograft recipients with negative T cell crossmatches to their donor; 152 of the patients were also tested for autoantibody to autologous B cells. Fifty-six (29%) had a positive B cell crossmatch (21 cold, 35 warm); 14 were autoantibody positive, 23 autoantibody negative, and 19 were not tested for autoantibody. There were no differences in HLA-A, B, C, or DR antigen disparity between the B cell positive (14, 0 DR mismatch; 25, 1 DR mismatch; 9, 0 DR mismatch) and the B cell negative group (40, 0 DR mismatch; 57, 1 DR mismatch; 13, 2 DR mismatch). Similarly, age, diabetic status, and number and type of pretransplant blood transfusions were comparable between B cell positive and negative groups. Although there were no hyperacute rejections, 2-year actuarial graft survival was significantly lower in the B cell positive group, regardless of donor source, graft number, or temperature of reaction. Patients with a positive B cell crossmatch, presumably due to demonstrable autoantibody, may have better graft survival rates than patients with a positive B cell crossmatch and no autoantibody.
D000328:Adult; D000918:Antibody Specificity; D001323:Autoantibodies / Q000032:analysis; D001402:B-Lymphocytes / Q000276:immunology*; D005260:Female; D006085:Graft Survival; D000949:Histocompatibility Antigens Class II / Q000276:immunology; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D007114:Immunization; D016030:Kidney Transplantation; D008297:Male; D013601:T-Lymphocytes / Q000276:immunology; D013696:Temperature
D001323:Autoantibodies; D000949:Histocompatibility Antigens Class II