Renal transplantation in sensitized recipients with positive luminex and negative CDC (complement-dependent cytotoxicity) crossmatches

Abstract

Recently, Luminex-crossmatch (LumXm) was introduced. The aim of this study was to evaluate clinical outcomes in sensitized recipients with a positive Luminex-crossmatch (LumXm (+)) and a negative complement-dependent cytotoxicity crossmatch (CDCXm (-)) after renal transplantation. Fifty-five renal transplant recipients with a CDCXm (-) and PRA class I or II ≥20% were enrolled in this study between February 2008 and December 2010 at Severance Hospital. Eighteen patients displayed LumXm (+) defined as LumXm positive class I or II and 37 patients displayed LumXm (-). Mean duration of follow-up was 18.9 ± 8.3 months. During this period, no patient death or graft loss occurred. The incidence of biopsy-proven or clinically presumed rejection was higher in the LumXm (+) group (n = 12, 66.7%) than in the LumXm (-) group (n = 6, 18.2%) (P = 0.001). All biopsy-proven acute rejections (n = 12) were diagnosed as acute cellular rejection. No significant difference in mean serum creatinine level or eGFR was observed between the groups at 18 months post-transplantation. The short-term outcome of renal transplantation in sensitized patients with a LumXm (+) and a CDCXm (-) may be considered to be acceptable. However, patients with a LumXm (+) have a substantially higher immunological risk for the development of acute cellular rejection.