Selective Elimination and Rationalization of Cell-based Assays in Deceased Donor Kidney Transplant Crossmatching.
| Autor: | Khalili M; Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, ON, Canada.; Division of Nephrology, University Health Network, University of Toronto, Toronto, ON, Canada., Famure O; Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, ON, Canada., Minkovich M; Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, ON, Canada., Tinckam KJ; Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, ON, Canada.; Division of Nephrology, University Health Network, University of Toronto, Toronto, ON, Canada., Kim SJ; Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, ON, Canada.; Division of Nephrology, University Health Network, University of Toronto, Toronto, ON, Canada. |
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| Jazyk: | angličtina |
| Zdroj: | Transplantation direct [Transplant Direct] 2024 Mar 07; Vol. 10 (4), pp. e1603. Date of Electronic Publication: 2024 Mar 07 (Print Publication: 2024). |
| DOI: | 10.1097/TXD.0000000000001603 |
| Abstrakt: | Background: While there is increasing reliance on a negative virtual crossmatch to proceed with deceased donor kidney transplantation, a flow cytometry crossmatch (FCXM) is still usually performed after the transplant has already occurred. Our center has eliminated pretransplant physical crossmatches for most patients, and since 2018, we have eliminated the systematic performance of posttransplant FCXMs. Methods: We studied all deceased donor kidney transplants in our program between June 1, 2018, and March 31, 2021, to evaluate the impact of eliminating retrospective FCXMs on resource utilization and graft outcomes (ie, the occurrence of antibody-mediated rejection [AMR] in the first 3-mo posttransplant). Results: A total of 358 kidney transplants occurred during the study period, and approximately 70% of these transplants proceeded without the performance of any FCXM. Incidence rates of AMR were low (9.63 per 1000 person-months), which compared favorably with the incidence rate of AMR during the 3-y period preceding the policy (4.82 per 1000 person-months, P = 0.21). Conclusions: Our results suggest that moving away from retrospective FCXM and relying exclusively on the virtual crossmatch is safe and efficient for kidney allocation. Competing Interests: The authors declare no funding or conflicts of interest. (Copyright © 2024 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.) |
| Databáze: | MEDLINE |
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