title: Effect of ABO incompatibility on T-cell flow cytometry cross-match results prior to living donor kidney transplantation.
abstract: Due to its high sensitivity, the flow cytometry cross-match (FCXM) has been described as valuable tool for identifying an optimal donor. We here focused on the impact of ABO incompatibility on FCXM results.
  
  
  
  We analyzed 29 ABO incompatible and 89 ABO compatible donor-recipient pairs (73 and 175 datasets, respectively) prior to living donor kidney transplantation. In all patients, lymphocytotoxic cross-matches for B and T cells were negative.
  
  
  
  Recipients with blood group O (A to O and B to O) displayed significantly (P < 0.05) higher T-FCXM results than those with blood group A and B (A to B, B to A and AB to A), respectively. Donor-specific T-FCXM responses (ΔMFI values) were significantly higher (P < 0.05) in ABO incompatible vs. compatible pairs (ABO incompatible recipients with blood group O: 32 ± 6; with blood group A: 19 ± 7; with blood group B: 7 ± 4; recipients with ABO compatibility: 3 ± 2, respectively, data represent mean ± SEM). Consistent with the T-FCXM results donor-specific isohemagglutinins (IgG titers) were significantly higher in recipients with blood group O vs. A, both prior to rituximab treatment and plasmapheresis/immune adsorption (P = 0.004) and immediately prior to transplantation, i.e., after rituximab and antibody-depleting therapies (P = 0.04).
  
  
  
  ABO incompatibility was associated with higher T-FCXM responses, especially in recipients with blood group O. This finding has major impact on the interpretation of flow cross-match results. Current cut-off values need to be reassessed in the ABO incompatible setting. © 2016 International Clinical Cytometry Society.
authors.affiliation: Institute for Transfusion Medicine, University Hospital, Essen, Germany.
authors.forename: M
authors.identifier: 0000-0001-6708-4390
authors.initials: M
authors.lastname: Lindemann
authors.affiliation: Institute for Transfusion Medicine, University Hospital, Essen, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Lenz
authors.affiliation: Institute for Transfusion Medicine, University Hospital, Essen, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Nyadu
authors.affiliation: Institute for Transfusion Medicine, University Hospital, Essen, Germany.
authors.forename: F M
authors.initials: FM
authors.lastname: Heinemann
authors.affiliation: Institute for Transfusion Medicine, University Hospital, Essen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Heinold
authors.affiliation: Department of Nephrology, University Hospital, Essen, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Guberina
authors.affiliation: Department of Nephrology, University Hospital, Essen, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Eisenberger
authors.affiliation: Campus Virchow Clinic, Center for Tumor Medicine, HLA Typing Laboratory, Charité University Medicine, Berlin, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Lachmann
authors.affiliation: Campus Virchow Clinic, Center for Tumor Medicine, HLA Typing Laboratory, Charité University Medicine, Berlin, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Schönemann
authors.affiliation: Department of Nephrology, University Hospital, Essen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kribben
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital, Essen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Paul
authors.affiliation: Institute for Transfusion Medicine, University Hospital, Essen, Germany.
authors.forename: P A
authors.initials: PA
authors.lastname: Horn
authors.affiliation: Department of Nephrology, University Hospital, Essen, Germany.|Department of Infectious Disease, University Hospital, Essen, Germany.
authors.forename: O
authors.initials: O
authors.lastname: Witzke
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005434:Flow Cytometry / Q000379:methods* / Q000592:standards; D006650:Histocompatibility Testing / Q000379:methods* / Q000592:standards; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes; D014181:Transplantation Immunology / Q000276:immunology; D055815:Young Adult
chemical_list: D000017:ABO Blood-Group System
keywords: ABO incompatible; flow cytometry cross-match; isohemagglutinin; living donor kidney transplantation; rituximab