Multicenter evaluation of a novel endothelial cell crossmatch test in kidney transplantation.

Published

Journal Article

BACKGROUND: Despite their clinical importance, clinical routine tests to detect anti-endothelial cell antibodies (AECA) in organ transplantation have not been readily available. This multicenter prospective kidney transplantation trial evaluates the efficacy of a novel endothelial cell crossmatch (ECXM) test to detect donor-reactive AECA associated with kidney allograft rejection. METHODS: Pretransplant serum samples from 147 patients were tested for AECA by a novel flow cytometric crossmatch technique (XM-ONE) using peripheral blood endothelial progenitor cells as targets. Patient enrolment was based on acceptance for transplantation determined by donor lymphocyte crossmatch results. RESULTS: Donor-reactive AECA were found in 35 of 147 (24%) patients. A significantly higher proportion of patients with a positive ECXM had rejections (16 of 35, 46%) during the follow-up of at least 3 months compared with those without AECA (13 of 112, 12%; P<0.00005). Both IgG and IgM AECAs were associated with graft rejections. Mean serum creatinine levels were significantly higher in patients with a positive ECXM test at 3 and 6 months posttransplant. CONCLUSIONS: XM-ONE is quick, easy to perform on whole blood samples and identifies patients at risk for rejection and reduced graft function not identified by conventional lymphocyte crossmatches.

Full Text

Duke Authors

Cited Authors

  • Breimer, ME; Rydberg, L; Jackson, AM; Lucas, DP; Zachary, AA; Melancon, JK; Von Visger, J; Pelletier, R; Saidman, SL; Williams, WW; Holgersson, J; Tydén, G; Klintmalm, GK; Coultrup, S; Sumitran-Holgersson, S; Grufman, P

Published Date

  • February 2009

Published In

Volume / Issue

  • 87 / 4

Start / End Page

  • 549 - 556

PubMed ID

  • 19307793

Pubmed Central ID

  • 19307793

Electronic International Standard Serial Number (EISSN)

  • 1534-6080

International Standard Serial Number (ISSN)

  • 0041-1337

Digital Object Identifier (DOI)

  • 10.1097/tp.0b013e3181949d4e

Language

  • eng