• DOI:10.12932/AP0569.34.1.2016
• Corpus ID: 10744063

Association between flow cytometric crossmatching and graft survival in Thai cadaveric-donor kidney transplantation.

@article{Kupatawintu2016AssociationBF,
  title={Association between flow cytometric crossmatching and graft survival in Thai cadaveric-donor kidney transplantation.},
  author={Pawinee Kupatawintu and Araya Tatawatorn and Nalinee Premasathian and Yingyos Avihingsanon and Asada Leelahavanichkul and Nattiya Hirankarn},
  journal={Asian Pacific journal of allergy and immunology},
  year={2016},
  volume={34 1},
  pages={
          86-93
        }
}

• P. Kupatawintu, Araya Tatawatorn, +3 authors N. Hirankarn
• Published 1 March 2016
• Medicine, Biology
• Asian Pacific journal of allergy and immunology

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 globulin-complement 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.