B-cell Complement Dependent Cytotoxic Crossmatch Positivity is an Independent Risk Factor for Long-term Renal Allograft Survival.
10.3346/jkms.2011.26.4.528
- Author:
Hyeon Seok HWANG
1
;
Hye Eun YOON
;
Bum Soon CHOI
;
Eun Jee OH
;
Ji Il KIM
;
In Sung MOON
;
Yong Soo KIM
;
Chul Woo YANG
Author Information
1. Transplantation Research Center, Seoul St. Mary's Hospital, Seoul, Korea. yangch@catholic.ac.kr
- Publication Type:Original Article ; Comparative Study ; Research Support, Non-U.S. Gov't
- Keywords:
B-cell;
Cytotoxicity Tests, Immunologic;
Kidney Transplantation
- MeSH:
Acute Disease;
Adult;
Aged;
B-Lymphocytes/*immunology;
Complement Activation;
Cytotoxicity Tests, Immunologic;
Female;
Graft Survival/*immunology;
Histocompatibility Testing/*methods;
Humans;
*Kidney Transplantation/immunology;
Male;
Middle Aged;
Prognosis;
Retrospective Studies;
Risk Factors;
Survival Analysis;
T-Lymphocytes/immunology;
Transplantation, Homologous
- From:Journal of Korean Medical Science
2011;26(4):528-533
- CountryRepublic of Korea
- Language:English
-
Abstract:
The clinical significance of positive B-cell complement-dependent cytotoxicity crossmatching (B-CDC) in renal transplant recipients remains unclear. We reviewed 20 recipients with isolated B-CDC positivity at the time of transplantation. We compared the clinical characteristics, acute rejection and long-term graft survival between positive and negative B-CDC patients (n = 602). The number of retransplant recipients and positivity for T- and B-flowcytometric crossmatch was greater in positive B-CDC patients than in negative B-CDC patients. The overall acute rejection rate of positive B-CDC patients was significantly higher (P < 0.001), and Banff grade II or III cellular rejection was more frequently observed in positive B-CDC patients (P = 0.037). Compared with negative B-CDC patients, acute cellular rejection as a cause of graft loss was more prevalent (P = 0.020) and rescue rejection therapy was more frequently needed in positive B-CDC patients (P = 0.007). The allograft survival rate of positive B-CDC patients was significantly lower than that of negative B-CDC patients (P < 0.001), and B-CDC positivity independently increased the risk of allograft failure 2.31-fold (95% CI 1.15-4.67; P = 0.019) according to multivariate analysis. In conclusion, isolated B-CDC positivity is an independent long-term prognostic factor for allograft survival.
