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B-cell Complement Dependent Cytotoxic Crossmatch Positivity is an Independent Risk Factor for Long-term Renal Allograft Survival
Journal of Korean Medical Science ; : 528-533, 2011.
Article in English | WPRIM | ID: wpr-173910
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.
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Full text: Available Index: WPRIM (Western Pacific) Main subject: Prognosis / Transplantation, Homologous / Cytotoxicity Tests, Immunologic / Histocompatibility Testing / B-Lymphocytes / T-Lymphocytes / Survival Analysis / Acute Disease / Retrospective Studies / Risk Factors Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Adult / Aged / Female / Humans / Male Language: English Journal: Journal of Korean Medical Science Year: 2011 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Prognosis / Transplantation, Homologous / Cytotoxicity Tests, Immunologic / Histocompatibility Testing / B-Lymphocytes / T-Lymphocytes / Survival Analysis / Acute Disease / Retrospective Studies / Risk Factors Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Adult / Aged / Female / Humans / Male Language: English Journal: Journal of Korean Medical Science Year: 2011 Type: Article