The utility of cytolytic flow cytometry crossmatch before kidney transplantation.

Transplant Immunology
G MoszkowskaP Trzonkowski

Abstract

The donor/recipient matching in kidney transplantation is based on approved laboratory tests, which are complement-dependent cytotoxic crossmatch (CDC-XM) and flow cytometry crossmatch (FCXM). Both have some disadvantages: CDC-XM has low sensitivity, whereas FCXM does not differentiate between lytic vs. non-lytic alloantibodies. To find an improved method, we have developed a new crossmatch technique of cytolytic flow cytometry crossmatch (cFCXM), which allows for sensitive detection of clinically relevant complement-binding antibodies. The cFCXM assay detects dead cells with viability dye that ensue from the binding of allospecific lytic antibodies. In our study, 135 unsensitized kidney transplant recipients were recruited based on the CDC-XM and FCXM results and the clinical utility of cFCXM was evaluated. The 5-year follow-up for acute rejection incidents revealed that cFCXM could verify the clinical relevance of positive FCXM results as recipients with positive FCXM but negative CDC-XM had the same risk of rejection as patients with both negative CDC-XM/FCXM results. These findings suggest that cFCXM assay may provide more precise immunological risk assessment in kidney transplant recipients.

References

Dec 1, 2001·Journal of the American Society of Nephrology : JASN·Martin KarpinskiPeter Nickerson
Oct 12, 2004·Cytometry. Part B, Clinical Cytometry·Constanze SchönemannAbdulgabar Salama
Feb 14, 2006·Cytometry. Part B, Clinical Cytometry·Dong Il WonJang Soo Suh
May 6, 2008·Cytometry. Part B, Clinical Cytometry·Chee L SawHoward M Gebel
May 24, 2008·Experimental and Molecular Pathology·Julio C Delgado, David D Eckels
Sep 11, 2008·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·H S EngG R Russ
Oct 5, 2010·Current Opinion in Organ Transplantation·Ilias I N DoxiadisFrans H J Claas
Jan 26, 2011·Human Immunology·Sarah J HetrickAnnette M Jackson
Jan 10, 2018·World Journal of Transplantation·Mohammed Mahdi AlthafAhmed Mostafa Halawa
Jul 31, 2018·Transplantation Proceedings·G MoszkowskaP Trzonkowski

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