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Multicenter Study
. 2009 Feb 27;87(4):549-56.
doi: 10.1097/TP.0b013e3181949d4e.

Multicenter evaluation of a novel endothelial cell crossmatch test in kidney transplantation

Michael E Breimer  1 , Lennart Rydberg, Annette M Jackson, Donna P Lucas, Andrea A Zachary, Joseph K Melancon, Jon Von Visger, Ronald Pelletier, Susan L Saidman, Winfred W Williams Jr, Jan Holgersson, Gunnar Tydén, Göran K Klintmalm, Sonnya Coultrup, Suchitra Sumitran-Holgersson, Per Grufman
Affiliations
Multicenter Study

Multicenter evaluation of a novel endothelial cell crossmatch test in kidney transplantation

Michael E Breimer et al. Transplantation. .

Abstract

Background: Despite their clinical importance, clinical routine tests to detect anti-endothelial cell antibodies (AECA) in organ transplantation have not been readily available. This multicenter prospective kidney transplantation trial evaluates the efficacy of a novel endothelial cell crossmatch (ECXM) test to detect donor-reactive AECA associated with kidney allograft rejection.

Methods: Pretransplant serum samples from 147 patients were tested for AECA by a novel flow cytometric crossmatch technique (XM-ONE) using peripheral blood endothelial progenitor cells as targets. Patient enrolment was based on acceptance for transplantation determined by donor lymphocyte crossmatch results.

Results: Donor-reactive AECA were found in 35 of 147 (24%) patients. A significantly higher proportion of patients with a positive ECXM had rejections (16 of 35, 46%) during the follow-up of at least 3 months compared with those without AECA (13 of 112, 12%; P<0.00005). Both IgG and IgM AECAs were associated with graft rejections. Mean serum creatinine levels were significantly higher in patients with a positive ECXM test at 3 and 6 months posttransplant.

Conclusions: XM-ONE is quick, easy to perform on whole blood samples and identifies patients at risk for rejection and reduced graft function not identified by conventional lymphocyte crossmatches.

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