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Platelet crossmatching for kidney transplants by flow cytometry
G X Wang1, G Y Terashita, P I Terasaki
1University of California, Los Angeles Tissue Typing Laboratory 90024.
Transplantation
|December 1, 1989
Summary
Flow cytometry crossmatching for kidney transplants has a high false-positive rate. Using platelets as targets in crossmatching significantly reduces early kidney transplant failure, improving patient outcomes.
Area of Science:
- Nephrology
- Immunology
- Transplantation
Background:
- Flow cytometry crossmatching is standard for kidney transplants but has a high false-positive rate.
- A positive crossmatch often does not predict early graft failure.
Purpose of the Study:
- To reduce false-positive reactions in kidney transplant crossmatching.
- To improve the prediction of early graft failure using flow cytometry.
Main Methods:
- Retrospective analysis of kidney transplant recipients.
- Comparison of T cell crossmatching with platelet crossmatching using flow cytometry.
- Evaluation of one-month graft survival rates based on crossmatch results.
Main Results:
- Flow cytometry with T cells did not correlate with one-month failure rates.
- Positive platelet crossmatch was associated with 53% kidney failure within one month (vs. 15% with negative crossmatch, P < 0.002).
- This association remained statistically significant for first-time transplant patients (P < 0.04).
Conclusions:
- Platelet crossmatching by flow cytometry offers a simpler method to avoid early primary nonfunction.
- Platelet crossmatching minimizes false-positive reactions compared to traditional methods.
- This approach enhances the accuracy of pre-transplant assessments for kidney recipients.