PMID- 10773556
OWN - NLM
STAT- MEDLINE
DCOM- 20000620
LR  - 20190513
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 17
IP  - 4
DP  - 2000 Apr
TI  - The clinical significance of flow cytometry crossmatching in heart 
      transplantation.
PG  - 362-9
AB  - OBJECTIVE: Flow cytometry crossmatching (FCXM) is more sensitive than the 
      cytotoxic crossmatch in identifying preformed antibodies to donor alloantigens, 
      but its clinical importance is controversial. The objective of this study was to 
      determine the association of a FCXM with survival and incidence of vascular 
      rejection in cardiac transplant recipients with a negative cytotoxic crossmatch. 
      METHODS: Between 1993 and 1998, 357 heart transplant recipients with a negative T 
      cell cytotoxic crossmatch were studied by three-color FCXM to quantitate 
      anti-donor IgG reactions against B and T lymphocytes. Reactions positive against 
      both were consistent with human leukocyte antigen (HLA) Class I reactivity, and 
      those against B cells only were considered to be against HLA Class II antigens. 
      Endpoints were episodes of vascular rejection, death from acute and chronic 
      rejection and overall survival. RESULTS: Fifty patients were FCXM for Class 
      I-positive, 144 for Class II-positive, and 163 were negative. At 1 month, freedom 
      from vascular rejection was 64% in Class I patients, but 90% and 96% in Class II 
      or negative crossmatch patients (P<0.0001). Survival of the negative crossmatch 
      group was higher than either Class I or II groups (94%, 74% and 76%, 
      respectively, at 3 years; P<0.0001). Death from acute rejection was 3% and 2% at 
      3 years in negative or Class II-positive patients, but 19% in Class I patients 
      (P<0.0001). Death from chronic rejection occurred only in Class II patients 
      (P=0.002). CONCLUSIONS: Despite a negative T-cell cytotoxic crossmatch, a 
      positive flow cytometry crossmatch correlates with important clinical events 
      after heart transplantation.
FAU - Bishay, E S
AU  - Bishay ES
AD  - Section of Cardiac Transplantation and Mechanical Circulatory Assist Program, 
      Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic 
      Foundation, Cleveland, USA.
FAU - Cook, D J
AU  - Cook DJ
FAU - Starling, R C
AU  - Starling RC
FAU - Ratliff, N B Jr
AU  - Ratliff NB Jr
FAU - White, J
AU  - White J
FAU - Blackstone, E H
AU  - Blackstone EH
FAU - Smedira, N G
AU  - Smedira NG
FAU - McCarthy, P M
AU  - McCarthy PM
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Biopsy, Needle
MH  - Cause of Death
MH  - Child
MH  - Child, Preschool
MH  - Evaluation Studies as Topic
MH  - Female
MH  - *Flow Cytometry
MH  - Graft Rejection/immunology
MH  - Graft Survival/immunology
MH  - HLA Antigens/*analysis
MH  - Heart Transplantation/*immunology/*mortality/pathology
MH  - Histocompatibility Testing/*methods
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Ohio/epidemiology
MH  - Sensitivity and Specificity
MH  - Statistics, Nonparametric
MH  - Survival Analysis
EDAT- 2000/04/25 09:00
MHDA- 2000/06/24 11:00
CRDT- 2000/04/25 09:00
PHST- 2000/04/25 09:00 [pubmed]
PHST- 2000/06/24 11:00 [medline]
PHST- 2000/04/25 09:00 [entrez]
AID - S1010-7940(00)00363-8 [pii]
AID - 10.1016/s1010-7940(00)00363-8 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2000 Apr;17(4):362-9. doi: 
      10.1016/s1010-7940(00)00363-8.