B cell positive cross-match not due to anti-HLA Class I antibodies and first kidney graft outcome.
The effect of B cell cross-match (XM) was investigated in 680 first deceased-donor kidney transplants in a single centre from 1990 to 1999: 74 transplants presented a B-positive XM (Group 1) 606 had a B-negative XM (Group 2). The absence in Group 1 of weak/low-titre anti-HLA Class I antibodies was assured blocking anti-Class I reactivity by treating B cells with non-cytotoxic anti-beta2 microglobulin (alphabeta2 M) serum before XM. Graft survivals up to 5 years were not significantly different; some differences were nevertheless observed: HLA-A,B,DR mismatches influenced graft outcome in Group 1: patients with 0-2 mismatches had better survival than patients with 3-4. When analysed according DR mismatch, patients with 1 mismatch had worse graft survival than well matched patients (p<0.05). No significant difference depending on HLA match was observed in Group 2. Early acute rejection rate was similar in the Groups except the rejection episodes after one year: Group 1 had significantly more. 61/74 patients of Group 1 were retrospectively analysed for anti-HLA-DR,DQ reactivity: only 11/61 had anti-HLA-DR or DQ antibodies (3/11 were donor specific); graft survival and rejections were not significantly different in the patients with and without anti-HLA Class II antibodies. Anti-donor B cell reactivity, at XM, once excluded the presence of weak/low-titre anti-HLA Class I antibodies, did not influence first kidney graft survival.
Praticò-Barbato
Loredana
L
Transplant Immunology Service, San Giovanni Hospital, Via Santena 19, 10126 Torino, Italy.
Conca
Raffaele
R
Magistroni
Paola
P
Leonardi
Gianluca
G
Oda
Alice
A
Rosati
Federica
F
Leone
Ercolino
E
Tacconella
Maurizio
M
Roggero
Stefano
S
Segoloni
Giuseppe Paolo
GP
Amoroso
Antonio
A
D000328:Adult; D001402:B-Lymphocytes / Q000276:immunology / Q000378:metabolism; D000939:Epitopes; D005260:Female; D006084:Graft Rejection / Q000097:blood / Q000276:immunology* / Q000517:prevention & control; D006085:Graft Survival / Q000276:immunology; D015395:Histocompatibility Antigens Class I / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D007114:Immunization; D007518:Isoantibodies / Q000097:blood / Q000276:immunology*; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000939:Epitopes; D015395:Histocompatibility Antigens Class I; D007518:Isoantibodies