Multicenter evaluation of a novel endothelial cell crossmatch test in kidney transplantation

Michael E. Breimer, Lennart Rydberg, Annette M. Jackson, Donna P. Lucas, Andrea A. Zachary, Joseph K. Melancon, Jon Von Visger, Ronald Pelletier, Susan L. Saidman, Winfred W. Williams, Jan Holgersson, Gunnar Tydén, Göran K. Klintmalm, Sonnya Coultrup, Suchitra Sumitran-Holgersson, Per Grufman

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND.: Despite their clinical importance, clinical routine tests to detect anti-endothelial cell antibodies (AECA) in organ transplantation have not been readily available. This multicenter prospective kidney transplantation trial evaluates the efficacy of a novel endothelial cell crossmatch (ECXM) test to detect donor-reactive AECA associated with kidney allograft rejection. METHODS.: Pretransplant serum samples from 147 patients were tested for AECA by a novel flow cytometric crossmatch technique (XM-ONE) using peripheral blood endothelial progenitor cells as targets. Patient enrolment was based on acceptance for transplantation determined by donor lymphocyte crossmatch results. RESULTS.: Donor-reactive AECA were found in 35 of 147 (24%) patients. A significantly higher proportion of patients with a positive ECXM had rejections (16 of 35, 46%) during the follow-up of at least 3 months compared with those without AECA (13 of 112, 12%; P<0.00005). Both IgG and IgM AECAs were associated with graft rejections. Mean serum creatinine levels were significantly higher in patients with a positive ECXM test at 3 and 6 months posttransplant. CONCLUSIONS.: XM-ONE is quick, easy to perform on whole blood samples and identifies patients at risk for rejection and reduced graft function not identified by conventional lymphocyte crossmatches.

Original languageEnglish (US)
Pages (from-to)549-556
Number of pages8
JournalTransplantation
Volume87
Issue number4
DOIs
StatePublished - Feb 27 2009

Keywords

  • Alloantibodies
  • Crossmatch
  • Endothelium
  • Histocompatibility
  • Humoral allograft rejection
  • Kidney transplantation

ASJC Scopus subject areas

  • Transplantation

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