The strength of donor-specific antibody is a more reliable predictor of antibody-mediated rejection than flow cytometry crossmatch analysis in desensitized kidney recipients

Muhammad A. Mujtaba, William Goggins, Andrew Lobashevsky, Asif A. Sharfuddin, Muhammad S. Yaqub, Dennis P. Mishler, Zacharie Brahmi, Nancy Higgins, Martin M. Milgrom, Alejandro Diez, Tim Taber

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

The aim of this study was to evaluate the utility of donor-specific antibodies (DSA) and flow cytometry crossmatch (FCCM) as tools for predicting antibody-mediated rejection (AMR) in desensitized kidney recipients. Sera from 44 patients with DSA at the time of transplant were reviewed. Strength of DSA was determined by single antigen Luminex bead assay and expressed as mean fluorescence intensity (MFI). T- and B-cell FCCM results were expressed as mean channel shift (MCS). AMR was diagnosed by C4d deposition on biopsy. Incidence of early AMR was 31%. Significant differences in the number of DSAs (p=0.0002), cumulative median MFI in DSA class I (p=0.0004), and total (class I+class II) DSA (p<0.0001) were found in patients with and without AMR. No significant difference was seen in MCS of T and B FCCM (p=0.095 and p=0.307, respectively). The three-yr graft survival in desensitized patients with DSA having total MFI<9500 was 100% compared to 76% with those having total MFI>9500 (p=0.022). Desensitized kidney transplant recipients having higher levels of class I and total DSA MFI are at high risk for AMR and poor graft survival. Recipient DSA MFI appears to be a more reliable predictor of AMR than MCS of FCCM.

Original languageEnglish (US)
Pages (from-to)E96-E102
JournalClinical Transplantation
Volume25
Issue number1
DOIs
StatePublished - Jan 1 2011
Externally publishedYes

Keywords

  • Antibody-mediated rejection
  • Desensitization
  • Donor-specific antibodies
  • Flow cytometry
  • Graft survival
  • Kidney transplant

ASJC Scopus subject areas

  • Transplantation

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  • Cite this

    Mujtaba, M. A., Goggins, W., Lobashevsky, A., Sharfuddin, A. A., Yaqub, M. S., Mishler, D. P., Brahmi, Z., Higgins, N., Milgrom, M. M., Diez, A., & Taber, T. (2011). The strength of donor-specific antibody is a more reliable predictor of antibody-mediated rejection than flow cytometry crossmatch analysis in desensitized kidney recipients. Clinical Transplantation, 25(1), E96-E102. https://doi.org/10.1111/j.1399-0012.2010.01341.x