Phasing out the pre-transplant cytotoxicity crossmatch: Are we missing something?

Autor: Jamile Abud, Bruna Brasil Dal Pupo, Cynthia da Silva, Elizete Keitel, Valter Duro Garcia, Roberto Ceratti Manfro, Jorge Neumann
Jazyk: English<br />Portuguese
Rok vydání: 2021
Předmět:
Zdroj: Brazilian Journal of Nephrology, Vol 43, Iss 3, Pp 365-374 (2021)
Druh dokumentu: article
ISSN: 2175-8239
DOI: 10.1590/2175-8239-jbn-2019-0222
Popis: Abstract Introduction: The anti-human globulin-enhanced complement-dependent cytotoxicity crossmatch (AHG-CDCXM) assay has been used to assess the presence of donor-specific antibodies (DSA) in recipient’s serum before kidney transplantation. The flow cytometric crossmatch (FCXM) assay was first introduced as an additional test. The aim of this study was to clinically validate the single use of the FCXM assay. Methods: This study compared the outcomes of a cohort of kidney transplant patients that underwent FCXM only (FCXM group) versus a cohort of kidney transplant patients that underwent AHG-CDCXM (control group). Results: Ninety-seven patients in the FCXM group and 98 controls were included. All crossmatches in the control group were negative. One patient in the FCXM group had a positive B cell crossmatch. One year after transplantation, there were no significant differences in patient survival (p = 0.591) and graft survival (p = 0.692) between the groups. Also, no significant difference was found in the incidence of Banff ≥ 1A acute cellular rejection episodes (p = 0.289). However, acute antibody-mediated rejections occurred in 3 controls (p = 0.028). Conclusion: The results showed that discontinuing the AHG-CDCXM assay does not modify the clinical outcomes in a 1-year follow-up.
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