Sonia Mehrotra, Raj Kumar Sharma, Kavita Vishwakarma, Narayan Prasad, Amit Gupta, Dharmendra S. Bhadauria, Anupama Kaul
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引用次数: 1
Abstract
Sixty six patients were evaluated for donor specific anti HLA sensitization before they received ABO incompatible kidney transplantation. Each recipient was evaluated by complement dependent cytotoxicity (CDC) crossmatch, flow cytometric crossmatch, single antigen bead assay (SAB) and lysate based solid phase crossmatch .The desensitization protocol was started10 to 12 days prior kidney transplant for ABO incompatible and anti HLA incompatible transplants at our center. Patients were evaluated for antibody mediated rejection (ABMR), donor specific anti HLA sensitization, graft survival with anti HLA DSA positivity in ABO-incompatible kidney transplant recipients.
Antibody mediated rejection (ABMR) was seen in five (7.5%) out of 66 patients. In non-sensitized group-A, ABMR was seen in 4.0% and in sensitized group (group-B) ABMR was seen in 18.75% with DSA positivity. Graft loss within one month post-transplant was seen in 2 patients due to ABMR in the sensitized group -B with pre-transplant positive DSA and in none in the non-sensitized group-A (p value = 0.05). Both these two patients sensitized group -B had flow CM, SAB DSA and Lysate CM positivity, with total MFI strength by SAB was above 5000, these two patients with CDC and flow CM negative after desensitization and had SAB DSA MFI strength came down to ≤1000.In this study patient survival was 97% and graft survival was 95% at one year, at four years Patient survival was 91.6% and graft survival was 91.5% follow up period. Anti HLA DSA positivity with ABO- incompatibility is associated with poor graft survival.
期刊介绍：
To provide to national and regional audiences experiences unique to them or confirming of broader concepts originating in large controlled trials. All aspects of organ, tissue and cell transplantation clinically and experimentally. Transplantation Reports will provide in-depth representation of emerging preclinical, impactful and clinical experiences. -Original basic or clinical science articles that represent initial limited experiences as preliminary reports. -Clinical trials of therapies previously well documented in large trials but now tested in limited, special, ethnic or clinically unique patient populations. -Case studies that confirm prior reports but have occurred in patients displaying unique clinical characteristics such as ethnicities or rarely associated co-morbidities. Transplantation Reports offers these benefits: -Fast and fair peer review -Rapid, article-based publication -Unrivalled visibility and exposure for your research -Immediate, free and permanent access to your paper on Science Direct -Immediately citable using the article DOI
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