The Relevance Of Flow Cytometrıc Auto-Crossmatch To The Posttransplant Course Of Kıdney Transplant Recıpıents

Abstract

THE RELEVANCE OF FLOW CYTOMETRIC AUTO CROSSMATCH TO THEPOST TRANSPLANT COURSE OF KIDNEY TRANSPLANT RECIPIENTSDemir E. 1, Yegit O.O. 1, Erol A. 2, Usta Akgul S. 2, Caliskan B. 3, Caliskan Y. 1, Turkmen A.1, OguzSavran F. 2, Sever M.Ş. 1Istanbul Faculty of Medicine, Istanbul University, Division of Nephrology, Department ofInternal Medicine, Istanbul-Turkey 1 Istanbul Faculty of Medicine, Istanbul University,Department of Medical Biology, Istanbul-Turkey 2 Haseki Training and Research Hospital,Pediatric Infectious Diseases Unit, Istanbul-Turkey 3Introduction and aimsThe aim of this study was to investigate the effects of flow cytometric auto-crossmatch test onpost-tx events of kidney tx recipients.MethodsA total of thirty-five patients underwent living renal tx with positive flow cytometric autocrossmatch test were evaluated. The records of these 35 patients were compared to a controlgroup including 57 living kidney tx recipients with negative flow cytometric auto-cross matchtest [36 (63%) male, mean age:38±11 year]. Post-tx events of the study groups wereevaluated.ResultsThe study and control groups were matched with regard to age, gender and time of tx(p=0.206, p=0.762 and p=0.205, respectively). During the median post-tx follow up of 53.5(IQR 26.7-83.7) months biopsy confirmed chronic antibody mediated rejection (CAMR) wasdeveloped in 11.4% (n=4) of the patient and 1.8% (n=1) of the control groups (p=0.047). Thepatients in the study group had a significantly higher rate of recurrent glomerulonephritis(GN) after kidney tx (5/11, 46%) compared to control group (1/14, 7.1%) (p=0.026). Therewere no differences regarding first (1.24±0.20 vs 1.32±0.37) and 12th months (1.25±0.37 vs1.27±0.67) serum creatinine levels between study and control groups (p=0.286 and p=0.910,respectively). The rate of new onset diabetes after tx (NODAT) was significantly higher instudy group (n=7, 20%) compared to controls (n=0, 0%) (p<0.001).ConslusionsThe findings of this study suggest a potential role of auto-antibody causing positiveautocrossmatchtest, meanwhile increasing the risk of CAMR, recurrent GN and NODAT. Furtherstudies are required to clarify this issue.