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Immunoglobulin G-positive in B-cell cross-match decreases kidney allograft survival.

Authors
  • Fagundes, I
  • Michelon, T
  • Schoroeder, R
  • Fernandes, S
  • Sporleder, H
  • Canabarro, R
  • Rodrigues, H
  • Petry, M
  • Zanenga, D
  • Silveira, J
  • Montagner, J
  • Bortolotto, A
  • Keitel, E
  • Santos, A
  • Garcia, V
  • Neumann, J
Type
Published Article
Journal
Transplantation Proceedings
Publisher
Elsevier
Publication Date
Jan 01, 2005
Volume
37
Issue
6
Pages
2753–2754
Identifiers
PMID: 16182801
Source
Medline
License
Unknown

Abstract

We retrospectively studied all 1149 transplants performed at our center between 1993 and 2003 to determine the incidence and clinical effect of pretransplant B-positive cross-match on kidney graft survival. The patients were divided in two groups: B-negative (n = 1102) and B-positive in current sera (n = 47; 4.1%). AB-positive test was more frequent among regrafted patients (14% vs 3%; P = .00). Demographic data were not different between the groups. The overall rate of graft loss was similar (26% vs 24%, respectively; P = .86). However, early nonsurgical graft losses were more frequent among B-positive patients (46% vs 20%, respectively; P = .04). IgM was the most frequent immunoglobulin in the B-positive group (76% IgM and 24% IgG). There was no significant difference between B-negative and B-positive groups in the 1-, 5-, and 10-year graft survival rates (87% vs 83%, 73% vs 78%, 64% vs 66%, respectively; P = .87). The graft survival was significantly reduced comparing an IgG anti-B cell to the B-negative group (P = .03) as well as IgG compared to IgM (P = .004). In conclusion, only B-positive cross-match due to IgG decreased graft survival. Even though it is an uncommon situation (0.9%), this study stressed the clinical value of the B-cell cross-match as a tool to identify patients with a higher immunological risk.

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