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Renal transplantation performed across a positive crossmatch: A single centre experience

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Abstract

The importance of certain positive crossmatches (CM+) in kidney transplantation remains controversial. Fifty consecutive kidney transplants were performed across a CM+ between Jan. 1990 – April 1994. In 19 cases there was an isolated B-cell CM+ (Group I), in 24 an historic T-cell IgM CM+ (Group II) and in 7 an historic T-cell IgG CM+ (Group III). Comparing groups I:II:III: early acute rejection affected 32%, 42%, 57% of grafts; mean serum creatinine at 3 months was 166, 150, 229 umol/l (p<0.05); 1 yr graft survival was 95 per cent, 96 per cent, 71 per cent (p=0.09). In group III both graft losses were in the setting of an additional current B-cell CM+. Conclusions: Transplantation performed in either the presence of an isolated B-cell CM+ or in the presence of an historic T-cell IgM CM+ was associated with acceptable outcomes at 1 yr. An historic T-cell IgG CM+ was confirmed as a contraindication to transplantation in most circumstances, especially when coupled with a current B-cell CM+.

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Author notes

  1. S. F. Leavey

    Present address: University of Michigan, 1150 W. Medical Center Drive, 4570 MSRB II, 48109-0650, Ann Arbor, MI

Authors and Affiliations

  1. Departments of Nephrology, Tissue Typing, Beaumont Hospital, Dublin 9, Ireland

    S. F. Leavey, J. J. Walshe, D. O’Neill, N. Atkins, J. Donohoe & M. Carmody

  2. Department of Transplant Surgery, Beaumont Hospital, Dublin 9, Ireland

    D. Hickey

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  1. S. F. Leavey
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  2. J. J. Walshe
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  3. D. O’Neill
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  4. N. Atkins
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  5. J. Donohoe
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  6. D. Hickey
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  7. M. Carmody
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Leavey, S.F., Walshe, J.J., O’Neill, D. et al. Renal transplantation performed across a positive crossmatch: A single centre experience. I.J.M.S. 166, 245–248 (1997). https://doi.org/10.1007/BF02944244

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