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Multicenter evaluation of a novel endothelial cell crossmatch test in kidney transplantation.

Artikel i vetenskaplig tidskrift
Författare Michael Breimer
Lennart Rydberg
Annette M Jackson
Donna P Lucas
Andrea A Zachary
Joseph K Melancon
Jon Von Visger
Ronald Pelletier
Susan L Saidman
Winfred W Williams
Jan Holgersson
Gunnar Tydén
Göran K Klintmalm
Sonnya Coultrup
Suchitra Sumitran-Holgersson
Per Grufman
Publicerad i Transplantation
Volym 87
Nummer/häfte 4
Sidor 549-56
ISSN 1534-6080
Publiceringsår 2009
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för kirurgi
Institutionen för biomedicin, avdelningen för klinisk kemi och transfusionsmedicin
Sidor 549-56
Språk en
Länkar dx.doi.org/10.1097/TP.0b013e3181949...
Ämnesord Drug Therapy, Combination, Endothelium, Vascular, immunology, physiology, Flow Cytometry, Histocompatibility Testing, methods, Humans, Immunosuppressive Agents, therapeutic use, Isoantibodies, blood, Kidney Transplantation, immunology, Receptor, TIE-2, analysis, Sweden, United States
Ämneskategorier Klinisk immunologi

Sammanfattning

BACKGROUND: Despite their clinical importance, clinical routine tests to detect anti-endothelial cell antibodies (AECA) in organ transplantation have not been readily available. This multicenter prospective kidney transplantation trial evaluates the efficacy of a novel endothelial cell crossmatch (ECXM) test to detect donor-reactive AECA associated with kidney allograft rejection. METHODS: Pretransplant serum samples from 147 patients were tested for AECA by a novel flow cytometric crossmatch technique (XM-ONE) using peripheral blood endothelial progenitor cells as targets. Patient enrolment was based on acceptance for transplantation determined by donor lymphocyte crossmatch results. RESULTS: Donor-reactive AECA were found in 35 of 147 (24%) patients. A significantly higher proportion of patients with a positive ECXM had rejections (16 of 35, 46%) during the follow-up of at least 3 months compared with those without AECA (13 of 112, 12%; P<0.00005). Both IgG and IgM AECAs were associated with graft rejections. Mean serum creatinine levels were significantly higher in patients with a positive ECXM test at 3 and 6 months posttransplant. CONCLUSIONS: XM-ONE is quick, easy to perform on whole blood samples and identifies patients at risk for rejection and reduced graft function not identified by conventional lymphocyte crossmatches.

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