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Crossmatching considerations in renal transplantation
A L Kiran1, V Vijayalakshmi, K J Murthy
1Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad.
The Journal of the Association of Physicians of India
|August 1, 1996
Summary
This study on renal transplant patients found that multiple transfusions often led to negative crossmatches. Factors like pregnancies in females influenced crossmatch outcomes, while diabetes and hypertension showed no correlation.
Area of Science:
- Immunology
- Nephrology
- Transplantation
Background:
- Human Leukocyte Antigen (HLA) antibodies are critical in renal transplantation.
- Crossmatch assays predict graft survival by detecting pre-formed antibodies.
Purpose of the Study:
- To evaluate the impact of transfusions and patient factors on anti-HLA antibody screening in renal transplant recipients.
- To assess the correlation between crossmatch results and patient characteristics.
Main Methods:
- Screening of 73 renal transplant cases for anti-HLA antibodies using the standard lymphocytotoxicity assay.
- Analysis of crossmatch results in relation to transfusion history, patient demographics, and comorbidities.
Main Results:
- Six out of nine related transplantations with a 100% negative crossmatch were successful.
- A shift from positive to negative crossmatch was observed in 8.2% of patients.
- Increased transfusions (3-21) correlated with negative crossmatches in both males and females.
- Female crossmatch outcomes were variable due to factors like pregnancies and parity.
- No significant correlation was found between diabetes/hypertension and crossmatch assay outcomes.
Conclusions:
- Transfusion protocols may influence crossmatch negativity in renal transplant candidates.
- Patient-specific factors, particularly in females, contribute to variability in crossmatch results.
- Diabetes and hypertension do not appear to be significant factors affecting crossmatch outcomes in this cohort.