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KMID : 0375319960180020353
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Journal of Clinical Pathology and Quality Control
1996 Volume.18 No. 2 p.353 ~ p.362
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Application of Flow cytometric Crossmatches in Kidney transplantation
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이은엽
이봉우/도정화/서광석/이상욱/손한철/김순호/김병창/김우석
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Abstract
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Background:
Complement dependent cytotoxic crossmatch(CDCXM) has been widely used to detect preformed antibodies prior to kidney transplantation to prevent hyperacute rejection. But ther CDCXM is insensitive to detect lower levels of preformed antibodies.
So,
more lately flow cytometric crossmatch (FCXM) was described to detect donorm directed antibodies to T and B lymphocytes with immunofluorescent stain.
Methods:
To evaluate the clinical usefulness of FCXM, we performed both FCXM and CDCXM for 22 cases of living related or unrelated kidney transplant recipients and 27 cases of healthy controls.
Results:
Anti-HLA antibodies to T and B cells could be rapidly and easily detected by flow cytometry with dual-coloured immunofluorescence staining.
By the FCXM, positive results of increased antibody bindings could be detected to dilution of 1 : 512 and 1 : 256 in a positive control of anti-HLA-ABC sera with a titer of 1 : 32 and a positive patient with tite4r of 1 : 16 by the T cell
conventional
assay, respectively. Among 21 cases with negative T cell CDCXM, 2 cases(9.5%) had antibodies to T cells by FCXM and 8 cases(38%) had antibodies to B cells by FCXM. 4 cases(19%) had only B cell FCXM positive. Among 11 cases receiving
transplantation, 4
cases had rejection episodes after grafts, one of whom had T cell antibody, one had B cell antibody and two had neither B cell nor T cell antibody by FCXM.
Conclusion:
This study suggests that the described preoperative(FCXM) is more sensitive than the conventional crossmatch and can be useful to reduce graft failure and to define a population of renal transplantation who form at risk group.
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KEYWORD
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