Flow cytometry crossmatching to investigate kidney-biopsy-proven, antibody-mediated rejection in patients who develop de novo donor-specific antibodies

The appearance of de novo donor-specific anti-human leukocyte antigen antibodies (dnDSAs) after kidney transplantation is independently associated with poor long-term allograft outcomes. The objective of the present study was to evaluate the predictive value of a flow cytometry crossmatching (FC-XM)...

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Bibliographic Details
Published in:Transplant immunology 2020-08, Vol.61, p.101303-101303, Article 101303
Main Authors: Usureau, Cédric, Jacob, Valentine, Clichet, Valentin, Presne, Claire, Desoutter, Judith, Poulain, Coralie, Choukroun, Gabriel, Guillaume, Nicolas
Format: Article
Language:English
Subjects:
Adult
Aged
Antibody mediated rejection
Biopsy
Blood Grouping and Crossmatching - methods
Cross-matching
Crossmatch, crossmatching, HLA
Female
Flow Cytometry
Graft Rejection - diagnosis
Graft Rejection - immunology
Histocompatibility Testing
HLA Antigens - immunology
Humans
Isoantibodies - metabolism
Kidney - pathology
Kidney transplant
Kidney Transplantation
Life Sciences
Male
Middle Aged
Transplantation, Homologous
Young Adult
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Summary:The appearance of de novo donor-specific anti-human leukocyte antigen antibodies (dnDSAs) after kidney transplantation is independently associated with poor long-term allograft outcomes. The objective of the present study was to evaluate the predictive value of a flow cytometry crossmatching (FC-XM) assay after the appearance of dnDSAs related to antibody-mediated allograft rejection (ABMR) after kidney transplantation. A total of 89 recipients with dnDSAs after transplantation were included. The crossmatching results were compared with the dnDSA profile (the mean fluorescence intensity (MFI), the complement-binding activity, and the IgG subclass profile) and the biopsy's morphological features. Of the 89 patients, 59 (66%) were positive in an FC-XM assay, 17 (19%) had complement-binding DSAs, 55 (62%) were positive for IgG1 and/or IgG3 in a solid phase assay, and 45 (51%) had morphological biopsy features linked to ABMR. An FC-XM assay was unable to discriminate between cases with or without ABMR on biopsy findings; it had a low positive predictive value (
ISSN:0966-3274
1878-5492
DOI:10.1016/j.trim.2020.101303