Renal transplantation in sensitized recipients with positive luminex and negative CDC (complement-dependent cytotoxicity) crossmatches.
Recently, Luminex-crossmatch (LumXm) was introduced. The aim of this study was to evaluate clinical outcomes in sensitized recipients with a positive Luminex-crossmatch (LumXm (+)) and a negative complement-dependent cytotoxicity crossmatch (CDCXm (-)) after renal transplantation. Fifty-five renal transplant recipients with a CDCXm (-) and PRA class I or II ≥20% were enrolled in this study between February 2008 and December 2010 at Severance Hospital. Eighteen patients displayed LumXm (+) defined as LumXm positive class I or II and 37 patients displayed LumXm (-). Mean duration of follow-up was 18.9 ± 8.3 months. During this period, no patient death or graft loss occurred. The incidence of biopsy-proven or clinically presumed rejection was higher in the LumXm (+) group (n = 12, 66.7%) than in the LumXm (-) group (n = 6, 18.2%) (P = 0.001). All biopsy-proven acute rejections (n = 12) were diagnosed as acute cellular rejection. No significant difference in mean serum creatinine level or eGFR was observed between the groups at 18 months post-transplantation. The short-term outcome of renal transplantation in sensitized patients with a LumXm (+) and a CDCXm (-) may be considered to be acceptable. However, patients with a LumXm (+) have a substantially higher immunological risk for the development of acute cellular rejection.
Transplantation Surgery, Severance Hospital, Yonsei University Health System, Seoul, Korea.
Kyu Ha
KH
Huh
Myoung Soo
MS
Kim
Hae Jin
HJ
Kim
Dong Jin
DJ
Joo
Beom Seok
BS
Kim
Man Ki
MK
Ju
Soon Il
SI
Kim
Yu Seun
YS
Kim
D000328:Adult; D003165:Complement System Proteins / Q000276:immunology*; D003601:Cytotoxicity Tests, Immunologic / Q000379:methods; D003602:Cytotoxicity, Immunologic; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology* / Q000502:physiology; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000276:immunology
D006680:HLA Antigens; D003165:Complement System Proteins