Renal allograft survival in patients with positive B cell crossmatch to their donor

• Published in: Annals of surgery 1984, Vol.199 (1), p.75-78
• Main Authors: MORROW, C. E, SUTHERLAND, D. E. R, FRYD, D. S, NOREEN, H, SEGALL, M, BACH, F. H, NAJARIAN, J. S
• Format: Article
• Language: English
• Subjects: Adult; Antibody Specificity; Autoantibodies - analysis; B-Lymphocytes - immunology; Biological and medical sciences; Female; Graft Survival; Histocompatibility Antigens Class II - immunology; Histocompatibility Testing - methods; Humans; Immunization; Kidney Transplantation; Male; Medical sciences; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; T-Lymphocytes - immunology; Temperature
• ISSN: 0003-4932; 1528-1140
• DOI: 10.1097/00000658-198401000-00013

B cell crossmatches were performed at cold (4 C) and warm (22 C and 37 C) temperatures on 193 renal allograft recipients with negative T cell crossmatches to their donor; 152 of the patients were also tested for autoantibody to autologous B cells. Fifty-six (29%) had a positive B cell crossmatch (21 cold, 35 warm); 14 were autoantibody positive, 23 autoantibody negative, and 19 were not tested for autoantibody. There were no differences in HLA-A, B, C, or DR antigen disparity between the B cell positive (14, 0 DR mismatch; 25, 1 DR mismatch; 9, 0 DR mismatch) and the B cell negative group (40, 0 DR mismatch; 57, 1 DR mismatch; 13, 2 DR mismatch). Similarly, age, diabetic status, and number and type of pretransplant blood transfusions were comparable between B cell positive and negative groups. Although there were no hyperacute rejections, 2-year actuarial graft survival was significantly lower in the B cell positive group, regardless of donor source, graft number, or temperature of reaction. Patients with a positive B cell crossmatch, presumably due to demonstrable autoantibody, may have better graft survival rates than patients with a positive B cell crossmatch and no autoantibody.