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The flow cytometry crossmatch in kidney transplantation
D J Cook1, P I Terasaki, Y Iwaki
1UCLA Tissue Typing Laboratory, Department of Surgery, UCLA Center for Health Sciences.
Clinical Transplants
|January 1, 1987
Summary
Positive flow cytometry crossmatch (FCXM) reactions indicate sensitization, especially in regrafts and in females with prior pregnancies. These reactions are linked to primary nonfunction and lower graft survival rates, particularly with female, older, or nontrauma donors.
Area of Science:
- Transplant immunology
- Clinical transplantation
- Immunoserology
Background:
- The presence of donor-specific antibodies (DSAs) is a major barrier to successful organ transplantation.
- Flow cytometry crossmatch (FCXM) assays detect antibodies that can cause hyperacute or acute rejection.
- Understanding FCXM reactivity in specific patient and donor populations is crucial for improving transplant outcomes.
Purpose of the Study:
- To investigate the association between positive FCXM reactions and transplant outcomes.
- To identify patient and donor factors associated with positive FCXM.
- To evaluate the impact of positive FCXM on graft function and survival.
Main Methods:
- Retrospective analysis of transplant recipients.
- Performance of FCXM assays to detect pre-formed antibodies.
- Correlation of FCXM results with clinical outcomes, including primary nonfunction and graft survival.
Main Results:
- Positive FCXM reactions were linked to sensitization, particularly in recipients of regrafts, females, and those with prior pregnancies or historical antibody reactivity.
- Positive FCXM was associated with primary nonfunction, especially in transplants with female, older, or nontrauma donors.
- Low 3-month graft survival and poor graft function at 3 months were observed in FCXM-positive transplants, particularly those involving female, older, or nontrauma donors.
Conclusions:
- Positive FCXM reactions are significant indicators of sensitization and are associated with adverse transplant outcomes.
- Specific donor and recipient characteristics (female sex, older age, nontrauma donors, prior pregnancies) increase the risk of positive FCXM and poor graft outcomes.
- FCXM is a valuable tool for risk stratification in organ transplantation.