The outcome of the endothelial precursor cell crossmatch test in lymphocyte crossmatch positive and negative patients evaluated for living donor kidney transplantation
| Autor: | Jakob Nilsson, Mats Alheim, Jan Holgersson, Gunnar Tydén, Ayeda AlMahri |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Adolescent Lymphocyte Immunology Delayed Graft Function Human leukocyte antigen Gastroenterology Isoantibodies Young Adult chemistry.chemical_compound Postoperative Complications Predictive Value of Tests Internal medicine Living Donors Humans Immunology and Allergy Medicine Lymphocytes Child Prospective cohort study Kidney transplantation Creatinine biology business.industry Histocompatibility Testing Stem Cells Endothelial Cells General Medicine Middle Aged Prognosis medicine.disease Kidney Transplantation Transplantation Treatment Outcome medicine.anatomical_structure chemistry biology.protein Female Antibody business |
| Zdroj: | Human Immunology. 74:1437-1444 |
| ISSN: | 0198-8859 |
| Popis: | The presence of human leukocyte antigen (HLA) and non-HLA antibodies (Abs) in kidney transplant recipients is associated with graft rejections. This study reports the results of an endothelial precursor cell crossmatch (EPCXM) test for detection of non-HLA Abs and its correlation to lymphocyte crossmatch (LXM) test results, the degree and type of sensitization, and transplantation (Tx) outcome in patients evaluated for living donor (LD) kidney transplantation (KTx). Patients were tested before any pre-transplantation (pre-Tx) treatment and at Tx. Pre-Tx treatments included B cell depletion and Ab removal. Patient records were reviewed for assessment of renal graft function, results of biopsies, and identification of complications affecting the graft. Pre-Tx sera from 32% of the LD patients had IgG and/or IgM-binding donor EPCs. Twenty-five percent of the patients were EPCXM IgM+. Of the patients with negative LXM tests, 25% had EPC Abs mainly of IgM class not reactive with HLA. There was no difference in rejection frequency or serum creatinine levels between the EPCXM+ and EPCXM- groups. The pre-Tx EPCXM+ group had significantly more patients with delayed graft function. Prospective studies with appropriate control groups are needed to establish whether pre-treatments aiming at removing anti-endothelial cell antibodies, as detected by the EPCXM pre-Tx, have a beneficial effect on short-term and long-term graft survival. |
| Databáze: | OpenAIRE |
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