title: In vivo heat inactivation of serum can distinguish false positive cross matches in renal transplants.
abstract: BACKGROUND
  Renal transplants have traditionally been performed despite positive cross match if results are presumptively due to IgM antibodies. False positives have been distinguishable from true positives by dithiothreitol or dithioerythritol treatment to inactivate IgM antibodies. Heat inactivation, which renders the antibodies inactive, is an alternative to chemical amelioration.
  
  
  METHODS
  We retrospectively evaluated clinical outcomes of patients who had positive cross matches presumed to be falsely positive as determined by treatment with heat inactivation compared to controls with negative cross matches over a six-year period. A total of 414 transplanted patients had available cross match data: 355 with a negative cross match and 59 with a positive cross match rendered negative after heat inactivation. Serum creatinine was reviewed at 6, 12 and 24 months posttransplant.
  
  
  RESULTS
  Graft function was considered stable at 12 and 24 months post-transplant if the change in creatinine compared to the 6-month value was &gt;0.5 mg/dL. Repeated and nonrepeated measures analysis showed equivalence in the change in sCr from 6 to 12 (p = 0.525) and from 6 to 24 months (p = 0.752). Kaplan-Meier curves to evaluate graft survival demonstrated no significant difference in function over 24 months. Curves were censored for patient death, treated as death with functioning (p = 0.48) and nonfunctioning (p = 0.64) grafts.
  
  
  CONCLUSIONS
  We have demonstrated comparable long-term function and survival for living donor renal transplants using heat inactivation to detect false positive cross matches. This simple and cost-effective method can be used to safely evaluate histocompatibility for living donor renal transplant recipients.
authors.affiliation: Pediatric Renal Section, Baylor College of Medicine, Houston, TX - USA.
authors.forename: Alyssa A
authors.initials: AA
authors.lastname: Riley
authors.affiliation: Allogen Laboratories, Cleveland Clinic, Cleveland, OH - USA.|Baylor College of Medicine, Dallas, TX - USA.
authors.forename: Lynne
authors.initials: L
authors.lastname: Klingman
authors.affiliation: Robley Rex Veterans Administration Medical Center and University of Louisville, Louisville, KY - USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Brier
authors.affiliation: Abbvie, North Chicago, IL - USA.|University of Illinois College of Medicine, Peoria, IL - USA.
authors.forename: Deepa H
authors.initials: DH
authors.lastname: Chand
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005189:False Positive Reactions; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000276:immunology*; D006648:Histocompatibility / Q000276:immunology*; D006650:Histocompatibility Testing / Q000379:methods*; D006358:Hot Temperature; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology*; D016030:Kidney Transplantation; D019520:Living Donors; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007075:Immunoglobulin M