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Pre-Transplant Donor Specific Antibody With Negative Flow-Crossmatch Was Related to Higher Acute Rejection But Not to Poor Graft Survival

A. Guichard-Romero, L. Marino-Vazquez, M. Lopez, N. Castelan, A. De-Santiago, N. Uribe-Uribe, J. Alberu, L. Morales-Buenrostro.

Nephrology, Transplantation, and Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

Meeting: 2015 American Transplant Congress

Abstract number: 371

Keywords: Graft survival, HLA antibodies, Kidney transplantation, Rejection

Session Information

Date: Tuesday, May 5, 2015

Session Name: Concurrent Session: Kidney: Antibodies and Allograft Injury

Session Time: 2:15pm-3:45pm

 Presentation Time: 2:27pm-2:39pm

Location: Room 118-AB

Related Abstracts
  • Preexisting Donor Specific Antibody (DSA) with a Negative Flow Crossmatch (FCXM) Should Not Preclude Kidney Transplantation
  • Outcomes Following Positive Crossmatch Renal Transplantation Despite Failure To Convert to Negative Flow Crossmatch after Desensitization

Background: DSA have been associated to lower graft survival and a higher humoral rejection rate, but there is a concern about the clinical impact of pre-transplant DSA detected with Luminex and negative Flow-Crossmatch. The aim of this study is to compare acute rejection rate, graft survival, and patient survival in patient with DSA plus negative Flow-Crossmatch and those without DSA.

Methods: Prospective cohort study. From Jan/2004 to sep/2014 a total of 486 kidney transplant were performed. We compare those with pre-transplant DSA plus negative Flow-Crossmatch with those without DSA. The main outcome were acute rejection rate, humoral acute rejection rate, time to first rejection, graft and patient survival. Chi square test, Kaplan-Meier analysis and Log-Rank test were used.

Results: Only 397 patients with DSA determination were included for this analysis. Fifty six patients (14.10%) had pre-transplant DSA. Those patients with DSA had a higher risk for acute rejection (OR=2.4, p=0.015) and humoral rejection (OR=4.85, p<0.001), see figure A & B. Twenty five (6.30%) patients lost the kidney graft, and 12 (3.02%) patients died. There was not difference between both groups (with and w/o DSA) for graft survival and patients survival (Figure C,D).

Conclusions: Pre-transplant DSA with Negative Flow-Crossmatch, increased the risk for acute rejection and humoral rejection, but it was not associated with lower graft survival or lower patient survival.

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To cite this abstract in AMA style:

Guichard-Romero A, Marino-Vazquez L, Lopez M, Castelan N, De-Santiago A, Uribe-Uribe N, Alberu J, Morales-Buenrostro L. Pre-Transplant Donor Specific Antibody With Negative Flow-Crossmatch Was Related to Higher Acute Rejection But Not to Poor Graft Survival [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/pre-transplant-donor-specific-antibody-with-negative-flow-crossmatch-was-related-to-higher-acute-rejection-but-not-to-poor-graft-survival/. Accessed January 21, 2021.

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