[Can one graft with a positive cross-match?]. / Peut-on greffer avec un cross-match positif?
Nephrologie
; 18(5): 175-80, 1997.
Article
em Fr
| MEDLINE
| ID: mdl-9424594
ABSTRACT
Differential cross-matches have been proposed to allow immunised patients to be grafted, whereas the dogma of a global positive cross-match discarded them from renal transplantation. We report our one-center experience considering current T positive cross-match as the only contra-indication to grafting, as well as patients whose sera comprise specific anti-donor antibodies. A comprehensive characterization of the antibodies was achieved by identification of auto-antibodies and specification of IgM and IgG isotype, class I and class II specificities, as well as HLA specificities. The differential cross-match comprised an auto and an allo-cross-match, against T and B lymphocytes. Historical and current sera were analysed either untreated or after DTT-treatment, at +4 degrees C and +22 degrees C. We performed 79 renal transplantations across positive cross-matches, which were 20 historical T positive cross-matches, 26 historical B positive cross-matches and 33 current B positive cross-matches. Results and graft survival were strictly identical as those obtained in the transplantations achieved with negative cross-matches throughout the same period, especially in sensitized patients. Current positive B cell cross-matches due to IgG were associated with an increased risk for early graft failure. We conclude that differential cross-match is a safe strategy permitting immunised patients to be grafted.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Imunologia de Transplantes
/
Teste de Histocompatibilidade
/
Transplante de Rim
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
Fr
Revista:
Nephrologie
Ano de publicação:
1997
Tipo de documento:
Article