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2017 ; 27
(5
): 347-352
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Correlation of Pretransplant Donor-specific Antibody Assay Using Luminex
Crossmatch with Graft Outcome in Renal Transplant Patients
#MMPMID28904429
Vimal M
; Chacko MP
; Basu G
; Daniel D
Indian J Nephrol
2017[Sep]; 27
(5
): 347-352
PMID28904429
show ga
The significance of pretransplant anti-human leukocyte antigen antibody levels
that are detectable by more sensitive platforms (including the Luminex platform)
yet undetected by complement-dependent cytotoxicity (CDC) assay remains unclear.
The aim of this study was to determine the clinical significance of the
donor-specific antibody (DSA) assay Luminex crossmatch and its impact on
short-term renal graft outcome such as acute rejections, graft survival, and
graft function. The results of pretransplant DSA-lymphocyte crossmatching (LCXM)
assay in 126 renal allograft recipients whose CDCs crossmatches were negative
were retrospectively analyzed for correlation with posttransplant outcomes. Of
the 126 recipients, 32 (25.4%) had pretransplant DSA positive. Statistically
significant association was found between DSA-LCXM positivity with 14(th) day
estimated glomerular filtration rate (eGFR) (P = 0.05), DSA Class I with 3(rd) (P
= 0.014) and 6(th) month (P = 0.02) eGFR, DSA Class II with 14(th) day (P = 0.06)
and 1(st) month (P = 0.10) eGFR, mean fluorescent intensity (MFI) DSA with 7(th)
day (P = 0.08) and 14(th) day (P = 0.09) eGFR, and maximum MFI DSA with 7(th) day
eGFR (P = 0.09). The posttransplant eGFR was higher at various time intervals in
DSA-LCXM-negative patients as compared to DSA-positive patients. However,
pretransplant DSA-LCXM results did not predict the rejection episodes, graft
loss, and 1-year posttransplant 24 h urine protein. Pretransplant DSA detected by
LCXM in patients with a negative CDC does not predict adverse short-term
outcomes. However, the difference in posttransplant eGFR supports further
investigation in long-term effects.