title: Multicenter evaluation of a novel endothelial cell crossmatch test in kidney transplantation.
abstract: BACKGROUND
  Despite their clinical importance, clinical routine tests to detect anti-endothelial cell antibodies (AECA) in organ transplantation have not been readily available. This multicenter prospective kidney transplantation trial evaluates the efficacy of a novel endothelial cell crossmatch (ECXM) test to detect donor-reactive AECA associated with kidney allograft rejection.
  
  
  METHODS
  Pretransplant serum samples from 147 patients were tested for AECA by a novel flow cytometric crossmatch technique (XM-ONE) using peripheral blood endothelial progenitor cells as targets. Patient enrolment was based on acceptance for transplantation determined by donor lymphocyte crossmatch results.
  
  
  RESULTS
  Donor-reactive AECA were found in 35 of 147 (24%) patients. A significantly higher proportion of patients with a positive ECXM had rejections (16 of 35, 46%) during the follow-up of at least 3 months compared with those without AECA (13 of 112, 12%; P<0.00005). Both IgG and IgM AECAs were associated with graft rejections. Mean serum creatinine levels were significantly higher in patients with a positive ECXM test at 3 and 6 months posttransplant.
  
  
  CONCLUSIONS
  XM-ONE is quick, easy to perform on whole blood samples and identifies patients at risk for rejection and reduced graft function not identified by conventional lymphocyte crossmatches.
authors.affiliation: Department of Surgery, Sahlgrenska Academy at Göteborg University, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Breimer
authors.forename: Lennart
authors.initials: L
authors.lastname: Rydberg
authors.forename: Annette M
authors.initials: AM
authors.lastname: Jackson
authors.forename: Donna P
authors.initials: DP
authors.lastname: Lucas
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Zachary
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Melancon
authors.forename: Jon
authors.initials: J
authors.lastname: Von Visger
authors.forename: Ronald
authors.initials: R
authors.lastname: Pelletier
authors.forename: Susan L
authors.initials: SL
authors.lastname: Saidman
authors.forename: Winfred W
authors.initials: WW
authors.lastname: Williams
authors.forename: Jan
authors.initials: J
authors.lastname: Holgersson
authors.forename: Gunnar
authors.initials: G
authors.lastname: Tydén
authors.forename: Göran K
authors.initials: GK
authors.lastname: Klintmalm
authors.forename: Sonnya
authors.initials: S
authors.lastname: Coultrup
authors.forename: Suchitra
authors.initials: S
authors.lastname: Sumitran-Holgersson
authors.forename: Per
authors.initials: P
authors.lastname: Grufman
mesh_terms: D004359:Drug Therapy, Combination; D004730:Endothelium, Vascular / Q000276:immunology* / Q000502:physiology; D005434:Flow Cytometry; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007518:Isoantibodies / Q000097:blood*; D016030:Kidney Transplantation / Q000276:immunology*; D042787:Receptor, TIE-2 / Q000032:analysis; D013548:Sweden; D014481:United States
chemical_list: D007166:Immunosuppressive Agents; D007518:Isoantibodies; D042787:Receptor, TIE-2