The use of positive B cell flow cytometry crossmatch in predicting rejection among renal transplant recipients

Malak Kotb, Wendy C. Russell, Donna Hathaway, Lillian W. Gaber, A. Osama Gaber

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

We performed retrospective flow cytometry crossmatch (FCXM) on 106 renal graft recipients who were transplanted based on current T cell negative serologic crossmatch. T and B cell FCXMs were performed on current and historical peak reactive post-transplant sera using 1024-channel flow cytometer and the shift in median channel fluorescence (SMCF) over the negative control was calculated. Cut-off values for a positive T and B crossmatch, > 40 and > 80 SMCF, respectively, were determined based on previous retrospective analysis of the data in the context of clinical outcome in our center, and were 1.5 times the standard deviation (SD) above the mean median channel fluorescence (MCF) of normal sera controls. The 1-yr graft survival was 95% for the total group of patients studied, and 87% for the recipients who had a positive T cell FCXM. To focus on the influence of a positive B cell FCXM on the incidence of rejection, primary transplant recipients who had a negative T cell FCXM (n = 81) were studied. Fifteen of 30 (50%) recipients with a positive B cell FCXM experienced at least one rejection episode within the first year. By contrast, only 15 of 51 (29.4%) of patients with a negative B cell FCXM experienced rejection (p = 0.05). The mean B cell SMCF in the group of patients who had no rejections was 35 ± 59, while that of the group of patients who experienced at least one rejection was 97 ± 97 (p = 0.012). By comparison, the rejection rate among the retransplant patients was 44.4%, and the mean B cell SMCF in the group with rejection was 94 ± 75 while it was 5 ± 7 among retransplant patients who did not have rejection (p = 0.031). Eighty-six percent of sensitized (panel reactivity antibodies (PRA) > 10%) patients who had a B positive/T negative FCXM experienced rejection, compared to 33% (n = 6 out of 16) of the B negative/T negative sensitized patients (p = 0.03). Furthermore, 62% (n = 13 out of 21) of donor-recipient mismatched patients with a B positive/T negative FCXM experienced rejection, compared to 38% (n = 13 out of 35) of patients with T negative/B negative FCXM who were similarly mismatched (p = 0.064). These data demonstrate the value of a positive B cell FCXM for predicting post-transplant rejections particularly when evaluated in the context of prior sensitization and/or DR mismatching. Our results suggest that B cell FCXM may have significant clinical implications, justifying its use in post-transplant management of recipients who have other risk factors of rejection.

Original languageEnglish (US)
Pages (from-to)83-89
Number of pages7
JournalClinical Transplantation
Volume13
Issue number1 II
StatePublished - 1999

Fingerprint

Flow Cytometry
B-Lymphocytes
Kidney
Fluorescence
T-Lymphocytes
Transplant Recipients
Transplants
Graft Rejection
Graft Survival
Serum
Tissue Donors
Antibodies
Incidence

All Science Journal Classification (ASJC) codes

  • Transplantation
  • Immunology

Cite this

The use of positive B cell flow cytometry crossmatch in predicting rejection among renal transplant recipients. / Kotb, Malak; Russell, Wendy C.; Hathaway, Donna; Gaber, Lillian W.; Gaber, A. Osama.

In: Clinical Transplantation, Vol. 13, No. 1 II, 1999, p. 83-89.

Research output: Contribution to journalArticle

Kotb, Malak ; Russell, Wendy C. ; Hathaway, Donna ; Gaber, Lillian W. ; Gaber, A. Osama. / The use of positive B cell flow cytometry crossmatch in predicting rejection among renal transplant recipients. In: Clinical Transplantation. 1999 ; Vol. 13, No. 1 II. pp. 83-89.
@article{d32c6b56a9d34623890ae32a653d2197,
title = "The use of positive B cell flow cytometry crossmatch in predicting rejection among renal transplant recipients",
abstract = "We performed retrospective flow cytometry crossmatch (FCXM) on 106 renal graft recipients who were transplanted based on current T cell negative serologic crossmatch. T and B cell FCXMs were performed on current and historical peak reactive post-transplant sera using 1024-channel flow cytometer and the shift in median channel fluorescence (SMCF) over the negative control was calculated. Cut-off values for a positive T and B crossmatch, > 40 and > 80 SMCF, respectively, were determined based on previous retrospective analysis of the data in the context of clinical outcome in our center, and were 1.5 times the standard deviation (SD) above the mean median channel fluorescence (MCF) of normal sera controls. The 1-yr graft survival was 95{\%} for the total group of patients studied, and 87{\%} for the recipients who had a positive T cell FCXM. To focus on the influence of a positive B cell FCXM on the incidence of rejection, primary transplant recipients who had a negative T cell FCXM (n = 81) were studied. Fifteen of 30 (50{\%}) recipients with a positive B cell FCXM experienced at least one rejection episode within the first year. By contrast, only 15 of 51 (29.4{\%}) of patients with a negative B cell FCXM experienced rejection (p = 0.05). The mean B cell SMCF in the group of patients who had no rejections was 35 ± 59, while that of the group of patients who experienced at least one rejection was 97 ± 97 (p = 0.012). By comparison, the rejection rate among the retransplant patients was 44.4{\%}, and the mean B cell SMCF in the group with rejection was 94 ± 75 while it was 5 ± 7 among retransplant patients who did not have rejection (p = 0.031). Eighty-six percent of sensitized (panel reactivity antibodies (PRA) > 10{\%}) patients who had a B positive/T negative FCXM experienced rejection, compared to 33{\%} (n = 6 out of 16) of the B negative/T negative sensitized patients (p = 0.03). Furthermore, 62{\%} (n = 13 out of 21) of donor-recipient mismatched patients with a B positive/T negative FCXM experienced rejection, compared to 38{\%} (n = 13 out of 35) of patients with T negative/B negative FCXM who were similarly mismatched (p = 0.064). These data demonstrate the value of a positive B cell FCXM for predicting post-transplant rejections particularly when evaluated in the context of prior sensitization and/or DR mismatching. Our results suggest that B cell FCXM may have significant clinical implications, justifying its use in post-transplant management of recipients who have other risk factors of rejection.",
author = "Malak Kotb and Russell, {Wendy C.} and Donna Hathaway and Gaber, {Lillian W.} and Gaber, {A. Osama}",
year = "1999",
language = "English (US)",
volume = "13",
pages = "83--89",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell",
number = "1 II",

}

TY - JOUR

T1 - The use of positive B cell flow cytometry crossmatch in predicting rejection among renal transplant recipients

AU - Kotb, Malak

AU - Russell, Wendy C.

AU - Hathaway, Donna

AU - Gaber, Lillian W.

AU - Gaber, A. Osama

PY - 1999

Y1 - 1999

N2 - We performed retrospective flow cytometry crossmatch (FCXM) on 106 renal graft recipients who were transplanted based on current T cell negative serologic crossmatch. T and B cell FCXMs were performed on current and historical peak reactive post-transplant sera using 1024-channel flow cytometer and the shift in median channel fluorescence (SMCF) over the negative control was calculated. Cut-off values for a positive T and B crossmatch, > 40 and > 80 SMCF, respectively, were determined based on previous retrospective analysis of the data in the context of clinical outcome in our center, and were 1.5 times the standard deviation (SD) above the mean median channel fluorescence (MCF) of normal sera controls. The 1-yr graft survival was 95% for the total group of patients studied, and 87% for the recipients who had a positive T cell FCXM. To focus on the influence of a positive B cell FCXM on the incidence of rejection, primary transplant recipients who had a negative T cell FCXM (n = 81) were studied. Fifteen of 30 (50%) recipients with a positive B cell FCXM experienced at least one rejection episode within the first year. By contrast, only 15 of 51 (29.4%) of patients with a negative B cell FCXM experienced rejection (p = 0.05). The mean B cell SMCF in the group of patients who had no rejections was 35 ± 59, while that of the group of patients who experienced at least one rejection was 97 ± 97 (p = 0.012). By comparison, the rejection rate among the retransplant patients was 44.4%, and the mean B cell SMCF in the group with rejection was 94 ± 75 while it was 5 ± 7 among retransplant patients who did not have rejection (p = 0.031). Eighty-six percent of sensitized (panel reactivity antibodies (PRA) > 10%) patients who had a B positive/T negative FCXM experienced rejection, compared to 33% (n = 6 out of 16) of the B negative/T negative sensitized patients (p = 0.03). Furthermore, 62% (n = 13 out of 21) of donor-recipient mismatched patients with a B positive/T negative FCXM experienced rejection, compared to 38% (n = 13 out of 35) of patients with T negative/B negative FCXM who were similarly mismatched (p = 0.064). These data demonstrate the value of a positive B cell FCXM for predicting post-transplant rejections particularly when evaluated in the context of prior sensitization and/or DR mismatching. Our results suggest that B cell FCXM may have significant clinical implications, justifying its use in post-transplant management of recipients who have other risk factors of rejection.

AB - We performed retrospective flow cytometry crossmatch (FCXM) on 106 renal graft recipients who were transplanted based on current T cell negative serologic crossmatch. T and B cell FCXMs were performed on current and historical peak reactive post-transplant sera using 1024-channel flow cytometer and the shift in median channel fluorescence (SMCF) over the negative control was calculated. Cut-off values for a positive T and B crossmatch, > 40 and > 80 SMCF, respectively, were determined based on previous retrospective analysis of the data in the context of clinical outcome in our center, and were 1.5 times the standard deviation (SD) above the mean median channel fluorescence (MCF) of normal sera controls. The 1-yr graft survival was 95% for the total group of patients studied, and 87% for the recipients who had a positive T cell FCXM. To focus on the influence of a positive B cell FCXM on the incidence of rejection, primary transplant recipients who had a negative T cell FCXM (n = 81) were studied. Fifteen of 30 (50%) recipients with a positive B cell FCXM experienced at least one rejection episode within the first year. By contrast, only 15 of 51 (29.4%) of patients with a negative B cell FCXM experienced rejection (p = 0.05). The mean B cell SMCF in the group of patients who had no rejections was 35 ± 59, while that of the group of patients who experienced at least one rejection was 97 ± 97 (p = 0.012). By comparison, the rejection rate among the retransplant patients was 44.4%, and the mean B cell SMCF in the group with rejection was 94 ± 75 while it was 5 ± 7 among retransplant patients who did not have rejection (p = 0.031). Eighty-six percent of sensitized (panel reactivity antibodies (PRA) > 10%) patients who had a B positive/T negative FCXM experienced rejection, compared to 33% (n = 6 out of 16) of the B negative/T negative sensitized patients (p = 0.03). Furthermore, 62% (n = 13 out of 21) of donor-recipient mismatched patients with a B positive/T negative FCXM experienced rejection, compared to 38% (n = 13 out of 35) of patients with T negative/B negative FCXM who were similarly mismatched (p = 0.064). These data demonstrate the value of a positive B cell FCXM for predicting post-transplant rejections particularly when evaluated in the context of prior sensitization and/or DR mismatching. Our results suggest that B cell FCXM may have significant clinical implications, justifying its use in post-transplant management of recipients who have other risk factors of rejection.

UR - http://www.scopus.com/inward/record.url?scp=0032983642&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032983642&partnerID=8YFLogxK

M3 - Article

VL - 13

SP - 83

EP - 89

JO - Clinical Transplantation

JF - Clinical Transplantation

SN - 0902-0063

IS - 1 II

ER -