T-cell flow-cytometry crossmatch and long-term renal graft survival.
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.
Rebibou
J M
JM
EFS de Bourgogne/Franche-Comté, Laboratoire d'Histocompatibilité et Thérapeutique Immunomoléculaire, INSERM, U645, Besançon Cedex, France. jmrebibou@chu-besancon.fr
Bittencourt
M Carvalho
MC
Saint-Hillier
Y
Y
Chabod
J
J
Dupont
I
I
Bittard
H
H
Chalopin
J M
JM
Hervé
P
P
Tiberghien
P
P
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
D000906:Antibodies; D006680:HLA Antigens; D003165:Complement System Proteins