A prospective study evaluating the role of donor-specific anti-endothelial crossmatch (XM-ONE assay) in predicting living donor kidney transplant outcome

Jennifer R. Zitzner, Shivani Shah, Chunfa Jie, Wendy Wegner, Anat R. Tambur, John J. Friedewald

Research output: Contribution to journalArticle

Abstract

Anti-endothelial cell antibodies (AECAs) may play a role in allograft rejection. We prospectively tested 150 consecutive living donor kidney transplant recipients, with transplants performed at Northwestern Memorial Hospital between January and December 2010, using the donor-specific endothelial (XM-ONE) crossmatch. 88/150 Patients received standard of care (SOC) immunosuppression and analyzed separately, in addition to the complete study cohort. Patients were followed for one year and XM-ONE results were analyzed in relation to occurrence of acute rejection, proteinuria, serum creatinine levels, and biopsy proven fibrosis. No correlation was found between XM-ONE results and protocol or "for-cause" biopsy proven acute rejection or vasculopathy at 12. months. When IgG+ and IgM+ results of the XM-ONE assay were combined, a correlation with proteinuria at 12. months was observed (p= 0.047). Although IgG + XM-ONE results were associated with significantly higher creatinine at 6. months (p= 0.018), significance was lost at 12. months. Conversely, patients with an IgM + XM-ONE crossmatch had significantly lower creatinine at 1. month (p= 0.019), 3. months (p= 0.0045), and 6. months (p= 0.038) post-transplant, but lost statistical significance at 12. months (p= 0.67) post-transplant. In summary, the presence of AECAs as determined by a positive XM-ONE result was not predictive of overall poorer graft outcome after one year in our center.

Original languageEnglish (US)
Pages (from-to)1431-1436
Number of pages6
JournalHuman Immunology
Volume74
Issue number11
DOIs
StatePublished - Nov 1 2013

Keywords

  • AECAs
  • EPCs
  • ESRD
  • FSGS
  • HLA
  • MICA/MICB
  • SAB
  • SOC
  • UA

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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