PMID- 31818254
OWN - NLM
STAT- MEDLINE
DCOM- 20201104
LR  - 20201104
IS  - 1471-2369 (Electronic)
IS  - 1471-2369 (Linking)
VI  - 20
IP  - 1
DP  - 2019 Dec 9
TI  - Transplant outcomes in positive complement-dependent cytotoxicity- versus flow 
      cytometry-crossmatch kidney transplant recipients after successful 
      desensitization: a retrospective study.
PG  - 456
LID - 10.1186/s12882-019-1625-2 [doi]
LID - 456
AB  - BACKGROUND: Despite the obvious survival benefit compared to that among waitlist 
      patients, outcomes of positive crossmatch kidney transplantation (KT) are 
      generally inferior to those of human leukocyte antigen (HLA)-compatible KT. This 
      study aimed to compare the outcomes of positive complement-dependent cytotoxicity 
      (CDC) crossmatch (CDC + FC+) and positive flow cytometric crossmatch (CDC-FC+) 
      with those of HLA-compatible KT (CDC-FC-) after successful desensitization. 
      METHODS: We retrospectively analyzed 330 eligible patients who underwent KTs 
      between June 2011 and August 2017: CDC-FC- (n = 274), CDC-FC+ (n = 39), and 
      CDC + FC+ (n = 17). Desensitization protocol targeting donor-specific antibody 
      (DSA) involved plasmapheresis, intravenous immunoglobulin (IVIG), and rituximab 
      with/without bortezomib for positive-crossmatch KT. RESULTS: Death-censored graft 
      survival and patient survival were not different among the three groups. The 
      median estimated glomerular filtration rate was significantly lower in the 
      CDC + FC+ group than in the compatible group at 6 months (P < 0.001) and 2 years 
      (P = 0.020). Biopsy-proven rejection within 1 year of CDC-FC-, CDC-FC+, and 
      CDC + FC+ were 15.3, 28.2, and 47.0%, respectively. Urinary tract infections 
      (P < 0.001), Pneumocystis jirovecii pneumonia (P < 0.001), and cytomegalovirus 
      viremia (P < 0.001) were more frequent in CDC-FC+ and CDC + FC+ than in CDC-FC-. 
      CONCLUSIONS: This study showed that similar graft and patient survival was 
      achieved in CDC-FC+ and CDC + FC+ KT compared with CDC-FC- through DSA-targeted 
      desensitization despite the higher incidence of rejection and infection than that 
      in compatible KT.
FAU - Kim, Deok Gie
AU  - Kim DG
AD  - Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, 
      Republic of Korea.
FAU - Lee, Juhan
AU  - Lee J
AD  - Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of 
      Korea.
FAU - Park, Younhee
AU  - Park Y
AD  - Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, 
      Republic of Korea.
FAU - Kim, Myoung Soo
AU  - Kim MS
AD  - Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of 
      Korea.
AD  - The Research Institute for Transplantation, Yonsei University College of 
      Medicine, Seoul, Republic of Korea.
FAU - Jeong, Hyeon Joo
AU  - Jeong HJ
AD  - The Research Institute for Transplantation, Yonsei University College of 
      Medicine, Seoul, Republic of Korea.
AD  - Department of Pathology, Yonsei University College of Medicine, Seoul, Republic 
      of Korea.
FAU - Kim, Soon Il
AU  - Kim SI
AD  - Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of 
      Korea.
AD  - The Research Institute for Transplantation, Yonsei University College of 
      Medicine, Seoul, Republic of Korea.
FAU - Kim, Yu Seun
AU  - Kim YS
AD  - Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of 
      Korea.
AD  - The Research Institute for Transplantation, Yonsei University College of 
      Medicine, Seoul, Republic of Korea.
FAU - Kim, Beom Seok
AU  - Kim BS
AD  - The Research Institute for Transplantation, Yonsei University College of 
      Medicine, Seoul, Republic of Korea. DOCBSK@yuhs.ac.
AD  - Department of Internal Medicine, Yonsei University College of Medicine, Seoul, 
      Republic of Korea. DOCBSK@yuhs.ac.
FAU - Huh, Kyu Ha
AU  - Huh KH
AD  - Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of 
      Korea. khhuh@yuhs.ac.
AD  - The Research Institute for Transplantation, Yonsei University College of 
      Medicine, Seoul, Republic of Korea. khhuh@yuhs.ac.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20191209
PL  - England
TA  - BMC Nephrol
JT  - BMC nephrology
JID - 100967793
RN  - 0 (HLA Antigens)
RN  - 80295-33-6 (Complement C1q)
SB  - IM
MH  - Adult
MH  - Complement C1q/*metabolism
MH  - Female
MH  - Flow Cytometry/*methods
MH  - Follow-Up Studies
MH  - Graft Survival/*physiology
MH  - HLA Antigens/*blood
MH  - Histocompatibility Testing/*methods/mortality
MH  - Humans
MH  - Kidney Transplantation/*methods/mortality
MH  - Living Donors
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Survival Rate/trends
MH  - Transplant Recipients
MH  - Treatment Outcome
PMC - PMC6902609
OTO - NOTNLM
OT  - Desensitization
OT  - Donor-specific antibody
OT  - Kidney transplantation
OT  - Positive crossmatch
COIS- The authors declare that they have no competing interests.
EDAT- 2019/12/11 06:00
MHDA- 2020/11/05 06:00
PMCR- 2019/12/09
CRDT- 2019/12/11 06:00
PHST- 2019/04/29 00:00 [received]
PHST- 2019/11/14 00:00 [accepted]
PHST- 2019/12/11 06:00 [entrez]
PHST- 2019/12/11 06:00 [pubmed]
PHST- 2020/11/05 06:00 [medline]
PHST- 2019/12/09 00:00 [pmc-release]
AID - 10.1186/s12882-019-1625-2 [pii]
AID - 1625 [pii]
AID - 10.1186/s12882-019-1625-2 [doi]
PST - epublish
SO  - BMC Nephrol. 2019 Dec 9;20(1):456. doi: 10.1186/s12882-019-1625-2.