IMPROVED GRAFT-SURVIVAL FOR FLOW-CYTOMETRY AND ANTIHUMAN GLOBULIN CROSSMATCH-NEGATIVE RETRANSPLANT RECIPIENTS

被引:80
作者
KERMAN, RH
VANBUREN, CT
LEWIS, RM
DEVERA, V
BAGHDAHSARIAN, V
GEROLAMI, K
KAHAN, BD
机构
[1] Department of Surgery, University of Texas Medical School, Houston, TX
关键词
D O I
10.1097/00007890-199001000-00011
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
We compared our standard NIH (extended incubation) crossmatcfa (XM) with antihuman globulin (AHG) and flow cytometry XMs and correlated the results with rejection episodes and graft survivals. For 89 CsA-Pred, primary renal allograft recipients, AHG and/or FCXM results did not improve on the NIH-XM-negative (NEG) graft survival results,whether testing pretransplant or historical (Hx) sera. Similarly, there was no association of a positive (POS) AHG or FCXM with increased rejection episodes in these primary recipients. However,forretransplant (Re-Tx) recipients a neg AHG or FCXM did discriminate fewer rejections and an improved graft survival compared with the NIH-XM-neg. results. The overall one-year graft survival for the 47 Re-Tx recipients studied herein was 66% (based on a neg pre-Tx NIH-XM). Pre-Tx AHG-NEG, Re-Tx recipients displayed an improved graft survival compared with NIHXM NEG recipients (77% vs. 66%, P<0.05) and with AHG-POS recipients (77% vs. 47%, P<0.05). Similarly, pre-Tx, FCXM-NEG, Re-Tx recipients displayed improved graft survivals compared with NIH-XM-NEG recipients (83% vs. 66%, P<0.05) and FCXM-POS recipients (83% vs. 48%,jP<0.05). Re-Tx recipients displaying a POS AHG and/or FCXM experienced a significantly greater number of rejections than NEG-XM recipients (P<0.05, respectively). The AHG and FCXM results correlated with rejections and graft survivals whether testing pre-Tx or Hx high-PRA sera. Re-Tx recipients who were AHG-XM-NEG but FCXM-POS, experienced more rejection episodes than recipients who displayed a negative XM reactivity for both AHG and FCXM (P<0.02), but with no resulting differences in graft survival.HLA matching, pre-Tx blood transfusions and PRA did not impact on these crossmatch and graft survival results. Use of AHG and/or FCXMs for Re-Tx, but not primary, recipients should help to improve graft survival for these high-risk recipients. © 1990 by Williams and Wilkins.
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页码:52 / 56
页数:5
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