Publication: Association between flow cytometric crossmatching and graft survival in Thai cadaveric-donor kidney transplantation
Issued Date
2016-03-01
Resource Type
ISSN
22288694
0125877X
0125877X
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2-s2.0-84962601282
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Mahidol University
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SCOPUS
Bibliographic Citation
Asian Pacific Journal of Allergy and Immunology. Vol.34, No.1 (2016), 86-93
Suggested Citation
Pawinee Kupatawintu, Araya Tatawatorn, Nalinee Premasathian, Yingyos Avihingsanon, Asada Leelahavanichkul, Nattiya Hirankarn Association between flow cytometric crossmatching and graft survival in Thai cadaveric-donor kidney transplantation. Asian Pacific Journal of Allergy and Immunology. Vol.34, No.1 (2016), 86-93. doi:10.12932/AP0569.34.1.2016 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/40829
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Title
Association between flow cytometric crossmatching and graft survival in Thai cadaveric-donor kidney transplantation
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Abstract
© 2016, Allergy and Immunology Society of Thailand. All rights reserved. Background: The flow cytometry cross-match (FCXM) technique is a sensitive method and has been reported to predict and protect graft rejection more efficiently than the conventional complement-dependent cytotoxicity cross-match (CDCXM) and the anti-human globulincomplement dependent cytotoxicity (AHG-CDC) methods. Methods: We performed retrospective FCXM in 270 cadaveric donor kidney transplant patients with negative CDC and AHG. The correlation between FCXM with graft rejection and graft survival within 1 year to 3 years was analysed. Results: There were 97 (35.9%) samples with positive FCXM. Only 7 (2.6%) of the 270 samples had evidence of antibody-mediated rejection (AMR) at the first year, which increased to 10 (3.7%) AMR samples after 3 years. Interestingly, there was a significant association between FCXM results with the graft outcome at 1 year (P = 0.046). However, when the association was analysed at 3 years after transplantation, it did not reach statistical significance. FCXM detected concordant positive results in 4 out of 8 samples. These samples had mean fluorescence intensity (MFI) of the donor-specific antibody (DSA) higher than 2,000. The DSA was identified by a single antigen bead. Conclusion: Although positive FCXM, particularly for HLA class I, was significantly associated with graft loss from AMR within 1 year of transplantation in this study, there were a lot of FCXM false positives, as high as 35.9%. Additional studies are required to further assess the usefulness of FCXM in Thailand.