PMID: 2103154Jan 1, 1990Paper

Effect of positive crossmatch against donor B lymphocytes in kidney transplantation: a prospective one-center study

Clinical Transplants
M HourmantJ P Soulillou

Abstract

Circulating antibodies reacting with donor lymphocytes, increasingly found in patients awaiting a kidney graft, are a cause of transplantation delays. Some of these antibodies may not be detrimental to the graft, and their recognition could be beneficial for the treatment of immunized patients. In this chapter, we report on a prospective study of 138 cases of kidney transplantation performed against a positive crossmatch (CM) on donor B lymphocytes. In all cases, a negative reaction was required on donor T lymphocytes using recipient pregraft sera. Sera of 36.3% and 43.6% of first and second-graft recipients, respectively, were also reactive on unseparated donor total lymphocytes. First grafts performed against donor B lymphocytes reacted like those with a negative CM in terms of graft survival, rejection incidence, and graft function in the first year. Surprisingly, an uncommonly high rate of success was observed in second grafts performed against a positive donor B-lymphocyte CM as compared to those with a negative B-cell CM (93.5% vs 62.8% graft survival at 2 years; p less than 0.05). In addition, these patients had a decreased rejection incidence and significantly better graft function (p less than 0.05) as compared to thos...Continue Reading

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