title: B cell positive cross-match not due to anti-HLA Class I antibodies and first kidney graft outcome.
abstract: 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.
authors.affiliation: Transplant Immunology Service, San Giovanni Hospital, Via Santena 19, 10126 Torino, Italy.
authors.forename: Loredana
authors.initials: L
authors.lastname: Praticò-Barbato
authors.forename: Raffaele
authors.initials: R
authors.lastname: Conca
authors.forename: Paola
authors.initials: P
authors.lastname: Magistroni
authors.forename: Gianluca
authors.initials: G
authors.lastname: Leonardi
authors.forename: Alice
authors.initials: A
authors.lastname: Oda
authors.forename: Federica
authors.initials: F
authors.lastname: Rosati
authors.forename: Ercolino
authors.initials: E
authors.lastname: Leone
authors.forename: Maurizio
authors.initials: M
authors.lastname: Tacconella
authors.forename: Stefano
authors.initials: S
authors.lastname: Roggero
authors.forename: Giuseppe Paolo
authors.initials: GP
authors.lastname: Segoloni
authors.forename: Antonio
authors.initials: A
authors.lastname: Amoroso
mesh_terms: 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
chemical_list: D000939:Epitopes; D015395:Histocompatibility Antigens Class I; D007518:Isoantibodies