J Korean Med Sci.  2011 Apr;26(4):528-533. 10.3346/jkms.2011.26.4.528.

B-cell Complement Dependent Cytotoxic Crossmatch Positivity is an Independent Risk Factor for Long-term Renal Allograft Survival

• Hwang HS
• Yoon HE
• Choi BS
• Oh EJ
• Kim JI
• Moon IS
• Kim YS
• Yang CW

• KMID: 1777883
• DOI: http://doi.org/10.3346/jkms.2011.26.4.528

Abstract

The clinical significance of positive B-cell complement-dependent cytotoxicity crossmatching (B-CDC) in renal transplant recipients remains unclear. We reviewed 20 recipients with isolated B-CDC positivity at the time of transplantation. We compared the clinical characteristics, acute rejection and long-term graft survival between positive and negative B-CDC patients (n = 602). The number of retransplant recipients and positivity for T- and B-flowcytometric crossmatch was greater in positive B-CDC patients than in negative B-CDC patients. The overall acute rejection rate of positive B-CDC patients was significantly higher (P < 0.001), and Banff grade II or III cellular rejection was more frequently observed in positive B-CDC patients (P = 0.037). Compared with negative B-CDC patients, acute cellular rejection as a cause of graft loss was more prevalent (P = 0.020) and rescue rejection therapy was more frequently needed in positive B-CDC patients (P = 0.007). The allograft survival rate of positive B-CDC patients was significantly lower than that of negative B-CDC patients (P < 0.001), and B-CDC positivity independently increased the risk of allograft failure 2.31-fold (95% CI 1.15-4.67; P = 0.019) according to multivariate analysis. In conclusion, isolated B-CDC positivity is an independent long-term prognostic factor for allograft survival.

Keyword

B-cell; Cytotoxicity Tests, Immunologic; Kidney Transplantation

MeSH Terms

Acute Disease
Adult
Aged
B-Lymphocytes/*immunology
Complement Activation
Cytotoxicity Tests, Immunologic
Female
Graft Survival/*immunology
Histocompatibility Testing/*methods
Humans
*Kidney Transplantation/immunology
Male
Middle Aged
Prognosis
Retrospective Studies
Risk Factors
Survival Analysis
T-Lymphocytes/immunology
Transplantation, Homologous

Figure

• 

  Fig. 1 Comparison of allograft survival between positive and negative B-CDC patients. Note that the survival rates for positive B-CDC patients was significantly lower than negative B-CDC patients (P < 0.001).

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