Influence of donor specific HLA antibodies detected by Luminex in kidney graft survival: A multivariate analysis

Abstract Some studies have demonstrated the clinical relevance of a positive virtual crossmatch in graft survival; nevertheless, other donor and recipient variables influence the outcome of the transplant. The aim of this study was to investigate the relevance of a positive virtual crossmatch in the...

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Bibliographic Details
Published in:Human immunology 2013-05, Vol.74 (5), p.545-549
Main Authors: Caro-Oleas, J.L, González-Escribano, M.F, Gentil-Govantes, M.A, Acevedo, M.J, González-Roncero, F.M, Bernal-Blanco, G, Núñez-Roldán, A
Format: Article
Language:English
Subjects:
Adult
Aged
Allergy and Immunology
Antibodies - blood
Antibodies - immunology
Female
Graft Survival - immunology
Histocompatibility Testing - methods
Histocompatibility Testing - statistics & numerical data
HLA Antigens - immunology
Humans
Immunologic Techniques - methods
Kidney - immunology
Kidney Transplantation - immunology
Male
Middle Aged
Multivariate Analysis
Outcome Assessment (Health Care) - methods
Outcome Assessment (Health Care) - statistics & numerical data
Proportional Hazards Models
Risk Factors
Time Factors
Tissue Donors
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Summary:Abstract Some studies have demonstrated the clinical relevance of a positive virtual crossmatch in graft survival; nevertheless, other donor and recipient variables influence the outcome of the transplant. The aim of this study was to investigate the relevance of a positive virtual crossmatch in the graft survival performing a multivariate analysis including other pretransplant variables. A total of 879 deceased kidney transplantations were included. Univariate and multivariate analyses were performed using Cox regression model. After performing the multivariate analysis, a positive virtual crossmatch against class I (adjusted HR 6.613; 95% CI 3.222–13.573), class II (adjusted HR 2.419; 95% CI 1.170–5.002) and class I + II (adjusted HR 5.717; 95% CI 1.925–16.975) detected by single antigen Luminex was the variable conferring the greatest relative risk of graft loss. A positive virtual crossmatch predicts a worse kidney graft survival even after correction by other variables and therefore, transplantation of patients with positive virtual crossmatches should be avoided.
ISSN:0198-8859
1879-1166
DOI:10.1016/j.humimm.2013.01.010