BACKGROUND: At our transplant center, cardiac allograft recipients undergo transplantation following a negative IgG anti-human globulin (AHG) crossmatch (XM). Flow cytometry crossmatching (FCXM) is a more sensitive XM procedure than the AHG XM procedure, yet there is limited information regarding the clinical relevance of FCXM to cardiac allograft outcome. METHODS: FCXM was performed retrospectively using the pretransplant sera from 140 recipients of primary cardiac allografts who underwent transplantation after AHG-IgG-NEG XM. The FCXM results were correlated to posttransplant rejection and patient survival. RESULTS: All of the patients were auto-XM-NEG. Twenty-two of 140 patients (16%) displayed IgG(+) FCXM and had a significantly poorer 1-year survival rate than did 57 of the FCXM-NEG recipients (68% vs. 86%, P<0.02). Moreover, 50% of the IgG(+) FCXM recipients experienced early rejections (< or =14 days postoperatively) compared with only 16% for the FCXM-NEG recipients (P<0.01). The survival rate of 92% for IgM(+) FCXM recipients (n=37) was significantly improved compared with the 86% survival rate for FCXM-NEG control recipients (P<0.05), suggesting a protective role for IgM. Consistent with this interpretation is that the 1-year survival rate of 79% for the IgG, IgM FCXM(+) recipients (n=24) was significantly better than the 68% survival rate for the IgG(+) FCXM recipients (P<0.02). CONCLUSIONS: These data suggest that IgG(+) FCXM identifies a subset of AHG-IgG-NEG XM cardiac allograft recipients who are at risk for early rejections and poor survival. In contrast, the presence of IgM may be beneficial to survival.
BACKGROUND: At our transplant center, cardiac allograft recipients undergo transplantation following a negative IgG anti-human globulin (AHG) crossmatch (XM). Flow cytometry crossmatching (FCXM) is a more sensitive XM procedure than the AHG XM procedure, yet there is limited information regarding the clinical relevance of FCXM to cardiac allograft outcome. METHODS:FCXM was performed retrospectively using the pretransplant sera from 140 recipients of primary cardiac allografts who underwent transplantation after AHG-IgG-NEG XM. The FCXM results were correlated to posttransplant rejection and patient survival. RESULTS: All of the patients were auto-XM-NEG. Twenty-two of 140 patients (16%) displayed IgG(+) FCXM and had a significantly poorer 1-year survival rate than did 57 of the FCXM-NEG recipients (68% vs. 86%, P<0.02). Moreover, 50% of the IgG(+) FCXM recipients experienced early rejections (< or =14 days postoperatively) compared with only 16% for the FCXM-NEG recipients (P<0.01). The survival rate of 92% for IgM(+) FCXM recipients (n=37) was significantly improved compared with the 86% survival rate for FCXM-NEG control recipients (P<0.05), suggesting a protective role for IgM. Consistent with this interpretation is that the 1-year survival rate of 79% for the IgG, IgM FCXM(+) recipients (n=24) was significantly better than the 68% survival rate for the IgG(+) FCXM recipients (P<0.02). CONCLUSIONS: These data suggest that IgG(+) FCXM identifies a subset of AHG-IgG-NEG XM cardiac allograft recipients who are at risk for early rejections and poor survival. In contrast, the presence of IgM may be beneficial to survival.
Authors: Peter I Lobo; Amandeep Bajwa; Kailo H Schlegel; John Vengal; Sang J Lee; Liping Huang; Hong Ye; Umesh Deshmukh; Tong Wang; Hong Pei; Mark D Okusa Journal: J Immunol Date: 2012-01-18 Impact factor: 5.422
Authors: Peter I Lobo; Kailo H Schlegel; Amandeep Bajwa; Liping Huang; Elvira Kurmaeva; Binru Wang; Hong Ye; Thomas F Tedder; Gilbert R Kinsey; Mark D Okusa Journal: J Immunol Date: 2015-10-30 Impact factor: 5.422
Authors: Yan Topilsky; Manish J Gandhi; Tal Hasin; Laurie L Voit; Eugenia Raichlin; Barry A Boilson; John A Schirger; Brooks S Edwards; Alfredo L Clavell; Richard J Rodeheffer; Robert P Frantz; Sudhir S Kushwaha; Amir Lerman; Naveen L Pereira Journal: Transplantation Date: 2013-01-27 Impact factor: 4.939
Authors: Yan Topilsky; Eugenia Raichlin; Tal Hasin; Barry A Boilson; John A Schirger; Naveen L Pereira; Brooks S Edwards; Alfredo L Clavell; Richard J Rodeheffer; Robert P Frantz; Manish J Gandhi; Simon Maltais; Soon J Park; Richard C Daly; Amir Lerman; Sudhir S Kushwaha Journal: Transplantation Date: 2013-03-27 Impact factor: 4.939