Relationship between CDC cross-match in liver recipients and antibody screening by flow cytometry.
Several authors have shown that anti-donor antibodies before liver transplantation are associated with decreased graft survival. The aim of this study was to investigate the relationship between anti-donor antibodies detected by the CDC technique or by FlowPRA, and acute or chronic rejection as well as graft survival. Furthermore, we sought to determine whether anti-donor antibodies, detected by the CDC technique, correlated with those discovered by cytometric screening. The acute rejection incidence among patients with complement-dependent cytotoxicity positive CDC cross-match was similar to that for patients with a negative cross-match. None of the patients with a positive cross-match developed chronic rejection. Allograft survival was significantly lower among recipients with a positive T-lymphocyte cross-match. Indeed, the majority of recipients with positive CDC cross-matches displayed graft failures before first posttransplant year. The results of a positive FlowPRA determination were concordant with a positive CDC cross-match in 85.71% of cases. Our data demonstrate that pretransplant FlowPRA correlates with the final CDC cross-match results. This finding suggests that in the future prospective pretransplant antibody screening with FlowPRA or CDC techniques may be useful to identify high-risk recipients.
Muro
M
M
Immunology Service, University Hosptial Virgen de la Arrixaca, Murcia, Spain. manuel.muro@carm.es
Sánchez-Bueno
F
F
Marín
L
L
Torío
A
A
Moya-Quiles
M R
MR
Minguela
A
A
Montes
O
O
Guerra
N
N
Montes
M
M
Pérez-López
M J
MJ
Robles
R
R
Ramirez
P
P
García-Alonso
A M
AM
Parrilla
P
P
Alvarez-López
M R
MR
D000208:Acute Disease; D001323:Autoantibodies / Q000097:blood; D002487:Centers for Disease Control and Prevention, U.S.; D002908:Chronic Disease; D005434:Flow Cytometry / Q000379:methods; D006084:Graft Rejection / Q000276:immunology; D006085:Graft Survival; D006681:HLA-D Antigens / Q000276:immunology; D015395:Histocompatibility Antigens Class I / Q000276:immunology; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D016031:Liver Transplantation / Q000276:immunology*; D013030:Spain; D013601:T-Lymphocytes / Q000276:immunology; D014481:United States
D001323:Autoantibodies; D006681:HLA-D Antigens; D015395:Histocompatibility Antigens Class I