title: Value of donor-specific antibody detection in first-graft renal transplant recipients with a negative complement-dependent cytotoxic crossmatch.
abstract: OBJECTIVE
  The clinical significance of pretransplant donor specific antihuman leukocyte antigen antibodies that occur despite negative cytotoxicity crossmatches is still unclear. In this study, we assessed the impact of those antibodies on the outcome of renal transplants.
  
  
  METHODS
  Our study subjects consisted of 153 living-donor kidney transplant recipients whose pretransplant sera were available. All subjects had a negative complement-dependent cytotoxic crossmatch and were retrospectively evaluated for antihuman leukocyte antigen antibodies and their donor specificities by means of LABScan 100 Flow analyzer (Luminex Corporation, Texas, USA). The follow-up data of all subjects were reviewed.
  
  
  RESULTS
  Antihuman leukocyte antigen antibodies were detected in 49 patients, donor nonspecific antihuman leukocyte antigen antibodies were found in 33, and donor specific antihuman leukocyte antigen antibodies were identified in 16. There was a trend toward more acute rejection in the patients with antihuman leukocyte antigen antibodies (22%) than in those without antihuman leukocyte antigen antibodies (17%), but that difference had no statistical significance (P = .378). Patients with donor specific antihuman leukocyte antigen antibodies had a significantly higher incidence of acute cellular rejection (19% vs 6%, respectively) and vascular rejection (25% vs 6%, respectively) than did patients with donor nonspecific antihuman leukocyte antigen antibodies (P = .04).
  
  
  CONCLUSIONS
  Our results suggest that there is a higher incidence of acute rejection in patients with donor specific antihuman leukocyte antigen antibodies and a negative complement-dependent cytotoxic crossmatch; however, those factors had no statistically significant impact on patient or graft survival.
authors.affiliation: Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. khaledmahmoud2000@hotmail.com
authors.forename: Khaled Mohamed
authors.initials: KM
authors.lastname: Mahmoud
authors.forename: Amani Mostafa
authors.initials: AM
authors.lastname: Ismail
authors.forename: Hussein Attia
authors.initials: HA
authors.lastname: Sheashaa
authors.forename: Osama Ashry
authors.initials: OA
authors.lastname: Gheith
authors.forename: Mohamed Mohamed
authors.initials: MM
authors.lastname: Kamal
authors.forename: Mohamed Ahmed
authors.initials: MA
authors.lastname: Ghoneim
mesh_terms: D000293:Adolescent; D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000097:blood*; D003165:Complement System Proteins / Q000276:immunology*; D003601:Cytotoxicity Tests, Immunologic; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors; D055815:Young Adult
chemical_list: D000888:Antibodies, Anti-Idiotypic; D006680:HLA Antigens; D003165:Complement System Proteins