Flow cytometry crossmatch: a sensitive technique for assessment of acute rejection in renal transplantation

Piazza, A.; Adorno, D.; Poggi, E.; Borrelli, Laura A.; Buonomo, Oreste Claudio; Pisani, F.; Valeri, M; Torlone, N.; Camplone, C; Monaco, P. I.; Fraboni, Daniela; Casciani, Carlo Umberto

doi:10.1016/s0041-1345(98)00423-0

Cited by 31 publications

(30 citation statements)

References 12 publications

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“…The diagnosis of acute humoral rejection was based on: 1) clinical evidence of refractory rejection, resistant to steroid and antilymphocyte therapy; 2) typical pathologic features: neutrophils in peritubular capillaries and in glomeruli; fibrin thrombi in arterioles and glomeruli; vasculitis; and 3) the demonstration of donor‐specific alloantibodies in recipients’ serum at the time of rejection. Early diagnosis of antibody‐mediated rejection is very important, as this is a potentially reversible situation [10]. The pathological findings of humoral rejection are most important in the confirmation of the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Acute humoral rejection of kidney allografts in patients with a positive flow cytometry crossmatch (FCXM)

Takeda

Uchida

Haba

et al. 2000

Clinical Transplantation

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The patients with a positive flow cytometry crossmatch (FCXM) are categorized as a high-risk group causing hyperacute or accelerated acute rejection after kidney transplantation. According to the successful results of ABO-incompatible renal transplantation, we have performed the living related transplant operations in the recipients with positive FCXM for donor T cells, but having a negative complement-dependent lymphocytotoxic reaction test. We have followed the clinical course of 4 FCXM-positive patients, and 2 of them have developed acute humoral rejection. We report the strategies for FCXM-positive living kidney transplantations and the characteristics of pathological findings of acute humoral rejection in FCXM-positive renal transplants. We have had few episodes of acute humoral rejection in ABO-incompatible kidney transplantations under immunosuppressive regimens, including cyclophosphamide, but 2 patients of 4 with FCXM-positive kidney transplantations developed acute humoral rejections. The differences in immunosuppressive regimen between ABO-incompatible and FCXM-positive kidney transplantations concern anti-lymphocyte globulin (ALG) and splenectomy. We have not performed splenectomy and ALG administration in FCXM-positive kidney transplantations. Severe acute rejection episodes have been experienced on post-operative days 7 and 9 in 2 of 4 FCXM-positive recipients. The early acute rejection episodes were clinically and pathologically diagnosed as typical humoral rejections. We have examined an immunofluorescent study to prove the diagnosis of humoral rejection in FCXM-positive kidney transplantations; both immunoglobulin M and C3 were positive for the whole course of humoral rejection. The 2 patients with acute humoral rejection recovered after treatment with double filtration plasmapheresis or plasma exchange to remove their anti-donor antibodies. The gold standard of success in FCXM-positive kidney transplantations is to suppress the production and reduce the level of anti-donor antibodies after transplant operations.

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Section: Discussionmentioning

confidence: 99%

Acute humoral rejection of kidney allografts in patients with a positive flow cytometry crossmatch (FCXM)

Takeda

Uchida

Haba

et al. 2000

Clinical Transplantation

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“…The influence of donor-specific antibodies (DSA) formed after transplantation is still not fully understood. Several recent publications have indicated that de novo production of HLAabs after organ transplantation is associated with increased risk of acute and chronic rejection with the consequence of decreased graft survival [4,5].…”

Section: Introductionmentioning

confidence: 99%

Expansion of Humoral Donor-Specific Alloreactivity After Renal Transplantation Correlates With Impaired Graft Outcome

Varnavidou-Nicolaidou¹,

Iniotaki-Theodoraki

Doxiadis

et al. 2005

Human Immunology

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“…Numerous studies have indicated a 2-to 10-fold higher incidence of acute rejection in the presence of HLA antibodies [16,[17][18][19][20][21][22]. The CDC method is a functional test because it detects complement-fixing antibodies (immunoglobulin (Ig)-M, IgG1, and IgG3) and these antibodies have been regarded as detrimental to the graft [3].…”

Section: Role Of Hla Antibodies In Renal Allograft Rejectionmentioning

confidence: 99%

Clinical relevance of pretransplant human leukocyte antigen donor-specific antibodies in renal patients waiting for a transplant: A risk factor

Gupta

Sinnott

2009

Human Immunology

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Flow cytometry crossmatch: a sensitive technique for assessment of acute rejection in renal transplantation

Cited by 31 publications

References 12 publications

Acute humoral rejection of kidney allografts in patients with a positive flow cytometry crossmatch (FCXM)

Acute humoral rejection of kidney allografts in patients with a positive flow cytometry crossmatch (FCXM)

Expansion of Humoral Donor-Specific Alloreactivity After Renal Transplantation Correlates With Impaired Graft Outcome

Clinical relevance of pretransplant human leukocyte antigen donor-specific antibodies in renal patients waiting for a transplant: A risk factor

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