Improved graft outcome and reduced complications due to flow cytometric cross matching and DR matching in renal transplantation
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Lookup NU author(s): David Talbot,
Dr Brian Shenton,
Professor Thomas Lennard,
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Several previous studies, including our own, have indicated that flow cytometric assays can identify an at-risk population of kidney transplant recipients. We used the assay for recipient selection for a period of twelve months. Recipients with donor T cell-directed IgG were excluded from transplantation and those with B cell-directed IgG were treated with increased immuno-suppression. The transplants performed over this period (n = 126) were compared with an earlier series (n = 118) where, although the flow cytometric crossmatches were performed, the results did not influence patient management. In the series where the flow cytometric crossmatch was used in management, a lower failure rate was found at three months (P = 0.037 chi square), primary nonfunction was reduced (P < 0.0001, Mann-Whitney), rejection episodes were reduced (P < 0.0001, Mann-Whitney) and the hospital stay was shorter (P < 0.0001, Student's t). The risk factors of ischemic times, panel reactivity, exposure to previous grafts and A/B locus matching were identical between the two groups. However DR matching was found to be higher in the series with the improved results (P < 0.0001, Mann-Whitney). In view of the significant improvement in graft success and low complication rate, we intend to continue with the policy of recipient selection by flow cytometric crossmatching and DR matching.
Author(s): Talbot D, Cavanagh G, Coates E, Givan AL, Shenton BK, Lennard TWJ, Proud G, Taylor RMR
Publication type: Article
Publication status: Published
Print publication date: 01/04/1992
ISSN (print): 0041-1337
ISSN (electronic): 1534-6080
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