title: T-cell flow-cytometry crossmatch and long-term renal graft survival.
abstract: 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.
authors.affiliation: EFS de Bourgogne/Franche-Comté, Laboratoire d'Histocompatibilité et Thérapeutique Immunomoléculaire, INSERM, U645, Besançon Cedex, France. jmrebibou@chu-besancon.fr
authors.forename: J M
authors.initials: JM
authors.lastname: Rebibou
authors.forename: M Carvalho
authors.initials: MC
authors.lastname: Bittencourt
authors.forename: Y
authors.initials: Y
authors.lastname: Saint-Hillier
authors.forename: J
authors.initials: J
authors.lastname: Chabod
authors.forename: I
authors.initials: I
authors.lastname: Dupont
authors.forename: H
authors.initials: H
authors.lastname: Bittard
authors.forename: J M
authors.initials: JM
authors.lastname: Chalopin
authors.forename: P
authors.initials: P
authors.lastname: Hervé
authors.forename: P
authors.initials: P
authors.lastname: Tiberghien
mesh_terms: D000367:Age Factors; D000906:Antibodies / Q000276:immunology; D003165:Complement System Proteins / Q000276:immunology; D005260:Female; D005434:Flow Cytometry; D005544:Forecasting; D006085:Graft Survival / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D015996:Survival Rate; D013601:T-Lymphocytes / Q000276:immunology*; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D000906:Antibodies; D006680:HLA Antigens; D003165:Complement System Proteins