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A positive pre-transplant endothelial precursor cell crossmatch does not imply reduced long-term kindney graft function

Journal article
Authors Markus Gäbel
Ayeda AlMahri
Lennart Rydberg
Jan Holgersson
Michael Breimer
Published in SOJ Immunology
Volume 3
Issue 3
Pages 1-6
ISSN 2372-0948
Publication year 2015
Published at Institute of Clinical Sciences, Department of Surgery
Institute of Biomedicine, Department of Clinical Chemistry and Transfusion Medicine
Pages 1-6
Language en
Links dx.doi.org/10.15226/soji/3/3/00130
Keywords antibody-mediated rejection, anti-endothelial cell antibodies, crossmatch, kidney graft function, non-HLA
Subject categories Transplantation surgery

Abstract

A flow cytometric crossmatch test detecting antibodies specific for donor Endothelial Precursor Cells (EPC) was evaluated in a multicenter study in 2005-06. A Positive Pre-Transplant EPC Crossmatch (EPCXM) was associated with a higher frequency of early rejections and reduced renal function at three and six months. The long-term follow-up of all patients (n = 53/147) recruited at our center is reported. Patients were retrospectively evaluated regarding rejections, patient/ graft survival and renal function over a four-year follow-up. As for the whole multicenter study patient population, significantly more early rejections occurred in EPCXM positive compared to EPCXM negative patients (5/7 vs. 5/46, p = 0.002). The EPCXM positive group had higher SCr at three (183 vs. 118 μmol/l, p = 0.01) and six (172 vs. 124 μmol/l, p = 0.02) months compared to the EPCXM negative group, and measured Glomerular Filtration Rate (mGFR) was decreased in the EPCXM positive group at 6 months (50 vs. 29 ml/min, p = 0.01). SCr decreased and mGFR increased over time in the EPCXM negative group, while SCr increased slightly and mGFR decreased slightly in the EPCXM positive group eliminating the difference in renal function between the groups. A positive EPCXM pre-transplantation is associated with higher frequency of early graft rejections, but does not influence long (4 year) term renal function.

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