Living-donor kidney transplant in T-cell and B-cell flow cytometry crossmatch-positive patients

Soushi Terasaka, Hidehisa Kitada, Yasuhiro Okabe, Sayako Kawanami, Hiroshi Noguchi, Kyoko Miyamoto, akihiro tsuchimoto, Kosuke Masutani, Masao Tanaka

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: Complement-dependent cytotoxic crossmatch is an important indicator for kidney transplant. However, there is controversy about treatment for flow cytometry crossmatch-positive cases. Materials and Methods: This was a retrospective study of 127 living-donor kidney transplant recipients from May 2007 to July 2011. We divided patients into 115 flow cytometry crossmatch T-cell and B-cell- negative cases, and 12 T-cell and B-cell-positive cases. Both groups were given 20 mg basiliximab the day of surgery and 4 days after surgery. Common oral immunosuppressive agents used were tacrolimus, mycophenolate mofetil, and methylprednisolone. Flow cytometry crossmatch T-cell and B-cell-negative recipients started immunosuppression 7 days before surgery, T-cell and B-cell-positive recipients started immunosuppression 14 days before surgery. T-cell and B-cell-positive patients also received 200 mg rituximab 1 week before surgery, had 3 plasma exchange sessions before transplant, and received intravenous immunoglobulin 20 g/day during surgery and after surgery for 5 days. We measured flow-panel reactive antibodies of T-cell and B-cell-positive patients just before surgery to check desensitization efficiency. We evaluated patient survival, graft survival, graft function, and frequency of rejection and infectious diseases. Results: Patient survival and graft survival were 100% in both groups. Flow cytometry crossmatch T-cell and B-cell-positive cases had no rejection events, but T-cell and B-cell-negative groups developed rejection. There was no statistical difference in the incidence of infection and graft function. Flow-panel reactive antibody demonstrated improvement in all T-cell and B-cell-positive cases. Conclusions: In living-donor kidney transplant, flow cytometry crossmatch T-cell and B-cell-positive patients are still considered to be at high risk. Although this is a short-term outcome, all T-cell and B-cell-positive patients in this study achieved excellent results with appropriate preoperative and postoperative treatment.

Original languageEnglish
Pages (from-to)227-232
Number of pages6
JournalExperimental and Clinical Transplantation
Volume12
Issue number3
DOIs
Publication statusPublished - Jan 1 2014

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Living Donors
Flow Cytometry
B-Lymphocytes
T-Lymphocytes
Transplants
Kidney
Ambulatory Surgical Procedures
Graft Survival
Immunosuppression
Mycophenolic Acid
Plasma Exchange
Survival
Antibodies
Intravenous Immunoglobulins
Methylprednisolone
Tacrolimus
Immunosuppressive Agents
Communicable Diseases
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Transplantation

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Living-donor kidney transplant in T-cell and B-cell flow cytometry crossmatch-positive patients. / Terasaka, Soushi; Kitada, Hidehisa; Okabe, Yasuhiro; Kawanami, Sayako; Noguchi, Hiroshi; Miyamoto, Kyoko; tsuchimoto, akihiro; Masutani, Kosuke; Tanaka, Masao.

In: Experimental and Clinical Transplantation, Vol. 12, No. 3, 01.01.2014, p. 227-232.

Research output: Contribution to journalArticle

Terasaka, Soushi ; Kitada, Hidehisa ; Okabe, Yasuhiro ; Kawanami, Sayako ; Noguchi, Hiroshi ; Miyamoto, Kyoko ; tsuchimoto, akihiro ; Masutani, Kosuke ; Tanaka, Masao. / Living-donor kidney transplant in T-cell and B-cell flow cytometry crossmatch-positive patients. In: Experimental and Clinical Transplantation. 2014 ; Vol. 12, No. 3. pp. 227-232.
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AU - Noguchi, Hiroshi

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AU - tsuchimoto, akihiro

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