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, Kousuke 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 - Jun 2014

All Science Journal Classification (ASJC) codes

  • Transplantation

Fingerprint Dive into the research topics of 'Living-donor kidney transplant in T-cell and B-cell flow cytometry crossmatch-positive patients'. Together they form a unique fingerprint.

  • Cite this