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Article |

Improved Graft Survival in Cadaveric Renal Retransplantation by Flow Crossmatching

Paul W. Nelson, MD; Patty Eschliman; Charles F. Shield, MD; Mark I. Aeder, MD; Alan M. Luger, MD; George E. Pierce, MD; Christopher F. Bryan, PhD
Arch Surg. 1996;131(6):599-603. doi:10.1001/archsurg.1996.01430180025004.
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Objective:  To evaluate the role of flow cytometry crossmatching on graft survival in patients undergoing cadaveric renal retransplantation compared with our conventional antihuman globulin cytotoxic crossmatch.

Design:  In 1990, 6 of 7 transplantation centers in 1 organ procurement organization service area began performing cadaveric renal retransplantation only if the flow T-cell IgG crossmatch was negative. During that period, 1 center continued to use only the antihuman globulin T-cell IgG crossmatch. Prior to 1990, all centers used only the antihuman globulin T-cell IgG crossmatch as their crossmatch selection criterion for retransplantation. Regraft survival was compared between those centers by crossmatch selection criteria.

Patients:  Patient selection and immunosuppression decisions were made at the transplantation center.

Setting:  All flow cytometry crossmatches for all 7 centers participating in the evaluation were performed at the Histocompatibility Laboratory of the Midwest Organ Bank Inc, Westwood, Kan.

Results:  Graft survival is significantly better (P=.03 [logrank test]) in regrafts when the flow crossmatch is used to select patients for transplantation.

Conclusion:  Flow crossmatching improves graft survival in cadaveric renal retransplantation by identifying a subset of patients with donor-directed HLA class I antibodies that are not detectable by our conventional antihuman globulin crossmatch.(Arch Surg. 1996;131:599-603)


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