B-cell complement dependent cytotoxic crossmatch positivity is an independent risk factor for long-term renal allograft survival.

Abstract:

:The clinical significance of positive B-cell complement-dependent cytotoxicity crossmatching (B-CDC) in renal transplant recipients remains unclear. We reviewed 20 recipients with isolated B-CDC positivity at the time of transplantation. We compared the clinical characteristics, acute rejection and long-term graft survival between positive and negative B-CDC patients (n = 602). The number of retransplant recipients and positivity for T- and B-flowcytometric crossmatch was greater in positive B-CDC patients than in negative B-CDC patients. The overall acute rejection rate of positive B-CDC patients was significantly higher (P < 0.001), and Banff grade II or III cellular rejection was more frequently observed in positive B-CDC patients (P = 0.037). Compared with negative B-CDC patients, acute cellular rejection as a cause of graft loss was more prevalent (P = 0.020) and rescue rejection therapy was more frequently needed in positive B-CDC patients (P = 0.007). The allograft survival rate of positive B-CDC patients was significantly lower than that of negative B-CDC patients (P < 0.001), and B-CDC positivity independently increased the risk of allograft failure 2.31-fold (95% CI 1.15-4.67; P = 0.019) according to multivariate analysis. In conclusion, isolated B-CDC positivity is an independent long-term prognostic factor for allograft survival.

journal_name

J Korean Med Sci

authors

Hwang HS,Yoon HE,Choi BS,Oh EJ,Kim JI,Moon IS,Kim YS,Yang CW

doi

10.3346/jkms.2011.26.4.528

subject

Has Abstract

pub_date

2011-04-01 00:00:00

pages

528-33

issue

4

eissn

1011-8934

issn

1598-6357

journal_volume

26

pub_type

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