Relevance of Flow Cytometric Auto-Crossmatch to the Post-transplant Course of Kidney Transplant Recipients.
BACKGROUND
The crossmatch test is essential prior to kidney transplantation (tx) to confirm compatibility between the donor and the recipient. However, its results can be misleading due to "undetectable antibodies" in the recipient's serum. To establish if undetectable autoantibodies are responsible for a positive result, an auto-crossmatch test can be performed. In this study, we aim to determine the long-term prognostic value of auto-flow cytometric auto-crossmatch (FCXM) test on kidney survival in kidney tx recipients.


METHODS
The primary outcome variable was reduced renal function. Secondary endpoints were incidence of biopsy-confirmed chronic antibody-mediated rejection (CAMR) and recurrent glomerulonephritis (GN).


RESULTS
There were no differences regarding initial serum creatinine levels between the study and control groups (P = .441). Patients who had positive auto-B FCXM had a significantly reduced renal function compared with the control group (P = .016). Four patients developed biopsy-confirmed CAMR in the study group and 1 patient in the control group (P = .047). Five patients had biopsy-confirmed recurrent GN in the GN study group, and only 1 patient had recurrent GN in the GN control group (P = .026).


CONCLUSIONS
Kidney transplant recipients with positive auto-FCXM test had significantly reduced renal function and a higher incidence of recurrent GN and CAMR compared with the control group. The findings of this study suggest a potential role of auto-antibody causing positive auto-FCXM test result, meanwhile increasing the risk of CAMR, recurrent GN, and new-onset diabetes after tx.
Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. Electronic address: eroldemir83@yahoo.com.
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Demir
Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Yeğit
Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
A
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Erol
Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Akgül
Haseki Training and Research Hospital, Pediatric Infectious Diseases Unit, Istanbul, Turkey.
B
B
Çalışkan
Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Bayraktar
Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Y
Y
Çalışkan
Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Türkmen
Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
F O
FO
Savran
Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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MS
Sever
D000328:Adult; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D006084:Graft Rejection / Q000453:epidemiology* / Q000276:immunology; D006085:Graft Survival / Q000276:immunology*; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male