title: Impact of flow cytometry crossmatch B-cell positivity on living renal transplantation.
abstract: BACKGROUND
  Various studies have reported poorer graft survival among individuals displaying T-cell-positive flow cytometry crossmatches (FCXM). Good outcomes have been observed in immunologically high-risk patients with the use of rituximab, plasmapheresis, and γ-globulin. Because the relevance of FCXM B-cell-positivity (BCXM (+)) alone remains controversial, we examined its impact on living donor renal transplantations.
  
  
  METHODS
  We retrospectively studied 146 adult renal transplantation recipients from April 2007 to June 2012, dividing the patients into BCXM (+) (n = 31) versus BCXM (-) recipients (n = 115). We examined patient and graft survivals as well as rejection rates at 0 to 3, 3 to 12, and 12 to 24 months. We also determined the incidence of infectious diseases. We performed stepwise multivariate regression to identify risk factors contributing rejection episodes.
  
  
  RESULTS
  One-year patient and graft survivals were 100% in both groups. The BCXM (-) group have a 16.8% rejection probability whereas the BCXM (+) group, 33.2% (P = .201). There were no significantly differences in the incidence of infectious diseases. Only the rate of a sensitizing history was an independent risk factor for a rejection episode.
  
  
  CONCLUSIONS
  BCXM (+) showed only a tendency but not a significant impact on rejection episodes compared with BCXM (-); short-term graft survivals were similar.
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. Electronic address: k.k.530504@gmail.com.
authors.forename: K
authors.initials: K
authors.lastname: Kurihara
authors.forename: H
authors.initials: H
authors.lastname: Kitada
authors.forename: Y
authors.initials: Y
authors.lastname: Miura
authors.forename: S
authors.initials: S
authors.lastname: Terasaka
authors.forename: K
authors.initials: K
authors.lastname: Kaku
authors.forename: K
authors.initials: K
authors.lastname: Miyamoto
authors.forename: A
authors.initials: A
authors.lastname: Tsuchimoto
authors.forename: K
authors.initials: K
authors.lastname: Masutani
authors.forename: M
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D001402:B-Lymphocytes / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D006084:Graft Rejection; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies