title: Clinical evaluation of the endothelial tie-2 crossmatch in ABO compatible and ABO incompatible renal transplants.
abstract: The necessity of detection of other than the classical major histocompatibility complex (MHC) and MHC class I-related chain A (MICA) directed antibodies prior to organ transplantation has already been repeatedly reported. A commercial flow cytometric endothelial crossmatch (CM) using isolated peripheral blood tie-2 positive cells provides a tool to detect non-MHC antibodies in addition to antibodies directed to MHC class I and II. The vast majority of circulating tie-2 positive cells expresses HLA-DR but not the A, B blood group antigens. Tie-2 cells are circulating surrogate endothelial cells. In this retrospective study we evaluated the endothelial CM in 51 renal transplantations, 30 with ABO compatible grafts and 21 with ABO incompatible grafts. Fifteen of the ABO compatible recipients (group A) developed unexplained rejection episodes (RE) while the remaining 15 had no RE (group B). Five cases of group A and none of group B had a positive tie-2 CM before transplantation (p=0.042). A positive tie-2 CM was also correlated with graft failure in ABO compatible transplants (p=0.02). No significant correlation was found between a positive pre-transplant tie-2 CM and RE in the ABO incompatible group. This study strongly suggest that a positive tie-2 CM may predict post-transplantation complications in ABO compatible grafts while negative reactions are not predictive. The test is not significantly correlated with RE in ABO incompatible grafts possibly due to applied desensitization.
authors.affiliation: Immunology Department and National Tissue Typing Center, General Hospital of Athens "G. Gennimatas", 154 Mesogeion Avenue, 11527 Athens, Greece. Electronic address: mkafetzi@yahoo.gr.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Kafetzi
authors.forename: John N
authors.initials: JN
authors.lastname: Boletis
authors.forename: Christine A
authors.initials: CA
authors.lastname: Melexopoulou
authors.forename: Athanassios
authors.initials: A
authors.lastname: Tsakris
authors.forename: Aliki G
authors.initials: AG
authors.lastname: Iniotaki
authors.forename: Ilias I N
authors.initials: II
authors.lastname: Doxiadis
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology / Q000378:metabolism*; D000328:Adult; D002469:Cell Separation; D042783:Endothelial Cells / Q000276:immunology / Q000378:metabolism*; D005260:Female; D005434:Flow Cytometry; D006084:Graft Rejection / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D006680:HLA Antigens / Q000276:immunology; D006648:Histocompatibility; D006650:Histocompatibility Testing / Q000706:statistics & numerical data; D006801:Humans; D007518:Isoantibodies / Q000097:blood; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D042787:Receptor, TIE-2 / Q000378:metabolism; D012189:Retrospective Studies
chemical_list: D000017:ABO Blood-Group System; D006680:HLA Antigens; D007518:Isoantibodies; D042787:Receptor, TIE-2
keywords: ADCC; AMR; APAAP; AR; Alkaline Phosphatase-Anti-Alkaline Phosphatase; CMR; Cr–Cl; EC; IS; IVIg; MPA; PEC; PP; PRA; RTx; acute rejection; antibody dependent cell cytotoxicity; antibody mediated rejection; cellular mediated rejection; creatinine clearance; endothelial cell; immunosuppression; intravenous immunoglobulin; mTORi; mammalian target of rapamycin; mycophenolate acid; panel reactive antibody(ies); plasmapharesis; precursor endothelial cell; renal transplantation