PMID- 30712055
OWN - NLM
STAT- MEDLINE
DCOM- 20190322
LR  - 20200225
IS  - 1643-3750 (Electronic)
IS  - 1234-1010 (Print)
IS  - 1234-1010 (Linking)
VI  - 25
DP  - 2019 Feb 3
TI  - Comparison of Physical Crossmatch and Virtual Crossmatch to Identify Preexisting 
      Donor-Specific Human Leukocyte Antigen (HLA) Antibodies and Outcome Following 
      Kidney Transplantation.
PG  - 952-961
LID - 10.12659/MSM.914902 [doi]
AB  - BACKGROUND Physical crossmatch (PXM) and virtual crossmatch (VXM) are applied to 
      identify preexisting donor-specific human leukocyte antigen (HLA) antibodies in 
      patients awaiting kidney transplantation. Recently, high-resolution epitope 
      analysis has emerged as a novel strategy for VXM. A retrospective clinical study 
      compared PXM with VXM before kidney transplantation and recipient outcome 
      following transplantation. MATERIAL AND METHODS Between August 2017 and March 
      2018, 239 patients underwent crossmatching and 94 patients received a donor 
      kidney. A complement-dependent cytotoxicity (CDC) PXM assay and VXM using 
      serological and epitope analysis identified donor-specific antibodies (DSA). 
      Crossmatch results and clinical outcome at 3 months were compared. RESULTS VXM 
      identified serological DSA (sDSA), verified epitope DSA, and total epitope DSA in 
      74 (31.0%), 39 (16.3%), and 49 (20.5%) cases, respectively. Eleven cases (4.6%) 
      had a positive PXM detected by the CDC assay. Of 94 kidney transplant recipients, 
      21 had preexisting sDSA but were negative in PXM; there was 1 case of delayed 
      graft function (DGF) and no cases of hyperacute rejection or acute rejection. Of 
      the rest of the 73 recipients who were negative for sDSA, 8 had acute rejection 
      (P=0.253) and 19 had DGF (P=0.037). No significant differences were found in 
      graft survival at 3 months. CONCLUSIONS High-resolution epitope analysis 
      identified fewer cases with DSA compared with serological analysis. Because 
      patients with and without sDSA had a similar short-term outcome in the setting of 
      a negative PXM, the presence of preexisting sDSA, determined by VXM, should not 
      be an absolute contraindication for kidney transplantation.
FAU - Peng, Bo
AU  - Peng B
AD  - The Transplantation Center of The Third Xiangya Hospital, Central South 
      University, Changsha, Hunan, China (mainland).
AD  - Engineering and Technology Research Center for Transplantation Medicine of The 
      National Ministry of Health, Changsha, Hunan, China (mainland).
FAU - Zhuang, Quan
AU  - Zhuang Q
AD  - The Transplantation Center of The Third Xiangya Hospital, Central South 
      University, Changsha, Hunan, China (mainland).
AD  - Engineering and Technology Research Center for Transplantation Medicine of The 
      National Ministry of Health, Changsha, Hunan, China (mainland).
FAU - Yu, Meng
AU  - Yu M
AD  - The Transplantation Center of The Third Xiangya Hospital, Central South 
      University, Changsha, Hunan, China (mainland).
AD  - Engineering and Technology Research Center for Transplantation Medicine of The 
      National Ministry of Health, Changsha, Hunan, China (mainland).
FAU - Li, Junhui
AU  - Li J
AD  - The Transplantation Center of The Third Xiangya Hospital, Central South 
      University, Changsha, Hunan, China (mainland).
AD  - Engineering and Technology Research Center for Transplantation Medicine of The 
      National Ministry of Health, Changsha, Hunan, China (mainland).
FAU - Liu, Yun
AU  - Liu Y
AD  - The Transplantation Center of The Third Xiangya Hospital, Central South 
      University, Changsha, Hunan, China (mainland).
AD  - Engineering and Technology Research Center for Transplantation Medicine of The 
      National Ministry of Health, Changsha, Hunan, China (mainland).
FAU - Zhu, Lijun
AU  - Zhu L
AD  - The Transplantation Center of The Third Xiangya Hospital, Central South 
      University, Changsha, Hunan, China (mainland).
AD  - Engineering and Technology Research Center for Transplantation Medicine of The 
      National Ministry of Health, Changsha, Hunan, China (mainland).
FAU - Ming, Yingzi
AU  - Ming Y
AD  - The Transplantation Center of The Third Xiangya Hospital, Central South 
      University, Changsha, Hunan, China (mainland).
AD  - Engineering and Technology Research Center for Transplantation Medicine of The 
      National Ministry of Health, Changsha, Hunan, China (mainland).
LA  - eng
PT  - Journal Article
DEP - 20190203
PL  - United States
TA  - Med Sci Monit
JT  - Medical science monitor : international medical journal of experimental and 
      clinical research
JID - 9609063
RN  - 0 (Antibodies)
RN  - 0 (HLA Antigens)
RN  - 0 (Histocompatibility Antigens Class I)
SB  - IM
MH  - Adult
MH  - Antibodies/immunology
MH  - Blood Grouping and Crossmatching/*methods
MH  - Female
MH  - Graft Rejection/immunology
MH  - Graft Survival/immunology
MH  - HLA Antigens/blood/*classification/physiology
MH  - Histocompatibility Antigens Class I/immunology
MH  - Humans
MH  - Kidney Transplantation/methods
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Tissue Donors
PMC - PMC6369651
COIS- Conflict of interest None.
EDAT- 2019/02/04 06:00
MHDA- 2019/03/23 06:00
PMCR- 2019/02/03
CRDT- 2019/02/04 06:00
PHST- 2019/02/04 06:00 [entrez]
PHST- 2019/02/04 06:00 [pubmed]
PHST- 2019/03/23 06:00 [medline]
PHST- 2019/02/03 00:00 [pmc-release]
AID - 914902 [pii]
AID - 10.12659/MSM.914902 [doi]
PST - epublish
SO  - Med Sci Monit. 2019 Feb 3;25:952-961. doi: 10.12659/MSM.914902.