Journal Article

Impaired renal graft survival after a positive B-cell flow-cytometry crossmatch.

M C Bittencourt, J M Rebibou, Y Saint-Hillier, J Chabod, I Dupont, J M Chalopin, P Herve and P Tiberghien

in Nephrology Dialysis Transplantation

Volume 13, issue 8, pages 2059-2064
Published in print August 1998 | ISSN: 0931-0509
Published online August 1998 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/13.8.2059
Impaired renal graft survival after a positive B-cell flow-cytometry crossmatch.

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BACKGROUND: The clinical and immunological relevance of a positive B-cell flow-cytometry (B-FCXM) crossmatch in renal transplantation is still controversial. METHODS: We retrospectively analysed 145 consecutive cadaveric renal transplantations performed from May 1991 to September 1995 in our institution. All grafts were transplanted following a negative IgG T-cell complement-dependent cytotoxicity crossmatch (T-CDCXM). Concomitantly to CDCXM, B-cell and T-cell FCXM were performed and results were expressed as a mean fluorescence index (FI). Two groups were compared: 116 recipients grafted with a negative B-FCXM vs a group of 19 patients grafted with a positive B-FCXM. RESULTS: The two groups were similar for length of cold ischaemia, donor and recipient's age and degree of HLA mismatching. The proportion of patients with pre-transplant anti-HLA class I antibodies or a retransplantation was significantly increased in the positive B-FCXM group vs the negative B-FCXM group. Recipient survival at 48 months was not significantly different in the two groups. However, graft survival at 12 and 48 months was significantly poorer in the positive B-FCXM than in negative B-FCXM (68% vs 90% at 12 months: P = 0.007, and 57% vs 79% at 48 months: P = 0.02). Within the positive B-FCXM group, no differences were found in pre-transplant anti-HLA class I or II alloimmunization as well as retransplantation frequency between the patients who lost their graft and the patients who did not. CONCLUSION: Our results suggest that a pretransplant positive B-FCXM is associated with an impaired long-term graft survival in renal allotransplantation.

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Subjects: Nephrology

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