Renal transplantation performed across a positive crossmatch: A single centre experience

The importance of certain positive crossmatches (CM+) in kidney transplantation remains controversial, Fifty consecutive kidney transplants were performed across a CM+ between Jan, 1990-April 1994, In 19 cases there was an isolated B-cell CM+ (Group I), in 24 an historic T-cell IgM CM+ (Group II) and in 7 an historic T-cell IgG CM+ (Group III), Comparing groups I:II:III:early acute rejection affected 32%, 42%, 57% of grafts; mean serum creatinine at 3 months was 166, 150, 229 umol/l (p<0.05); 1 yr graft survival was 95 per cent, 96 per cent, 71 per cent (p=0.09), In group III both graft losses were in the setting of an additional current B-cell CM+, Conclusions: Transplantation performed in either the presence of an isolated B-cell CM+ or in the presence of an historic T-cell IgM CM+ was associated with acceptable outcomes at 1 yr, An historic T-cell IgG CM+ was confirmed as a contraindication to transplantation in most circumstances, especially when coupled with a current B-cell CM+.