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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
2
|
| pubmed:dateCreated |
1989-4-3
|
| pubmed:abstractText |
The significance of the antiglobulin crossmatch in the cyclosporine era remains controversial. Over an 11-month period, 124 recipients of cadaveric renal allografts (109 primary, 15 nonprimary) were retrospectively crossmatched via the antiglobulin technique. Criteria for recipient selection for transplantation included a negative T lymphocytotoxic (CDC) crossmatch for current and historical sera. Fourteen patients (11.3%) underwent transplantation in the setting of a negative T and positive antiglobulin crossmatch. The patient group included 10 female and 4 male patients with a mean age of 43.8 years. All but one patient received a primary transplant, and current sera were positive in the antiglobulin crossmatch in all cases. The mean HLA-ABDR match was 1.4 (range 0-4). Preoperative PRA titers ranged from 0 to 80% (mean 18.3%). All patients underwent successful renal transplantation with quadruple immunosuppression consisting of prednisone, azathioprine, and the sequential use of MALG/cyclosporine. There were no episodes of hyperacute rejection. However, 10 patients (71.4%) experienced acute rejection, including 7 episodes within 4 days of transplant. Early rejection was significantly more common in patients with a positive antiglobulin test (50% vs. 20.9%, P less than 0.05). The mean one-month serum creatinine was 1.7 mg/dl. Actual patient and allograft survival are 92.9% and 85.7%, respectively. Risk factors for a positive antiglobulin crossmatch included female sex and prior sensitization as measured by PRA. Although these patients represent a high-risk group for early rejection, no adverse effect on patient or graft survival was noted with quadruple immunotherapy. In conclusion, a positive antiglobulin crossmatch is no longer a contraindication to renal transplantation with current immunosuppressive strategies.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:chemical | |
| pubmed:status |
MEDLINE
|
| pubmed:month |
Feb
|
| pubmed:issn |
0041-1337
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
47
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
282-6
|
| pubmed:dateRevised |
2004-11-17
|
| pubmed:meshHeading |
pubmed-meshheading:2645713-Adolescent,
pubmed-meshheading:2645713-Adult,
pubmed-meshheading:2645713-Aged,
pubmed-meshheading:2645713-Antibodies, Anti-Idiotypic,
pubmed-meshheading:2645713-Antilymphocyte Serum,
pubmed-meshheading:2645713-Cadaver,
pubmed-meshheading:2645713-Child,
pubmed-meshheading:2645713-Cytotoxicity Tests, Immunologic,
pubmed-meshheading:2645713-Drug Therapy, Combination,
pubmed-meshheading:2645713-Female,
pubmed-meshheading:2645713-Follow-Up Studies,
pubmed-meshheading:2645713-Graft Rejection,
pubmed-meshheading:2645713-Graft Survival,
pubmed-meshheading:2645713-Humans,
pubmed-meshheading:2645713-Immunosuppressive Agents,
pubmed-meshheading:2645713-Kidney Transplantation,
pubmed-meshheading:2645713-Male,
pubmed-meshheading:2645713-Middle Aged,
pubmed-meshheading:2645713-Retrospective Studies,
pubmed-meshheading:2645713-Risk Factors
|
| pubmed:year |
1989
|
| pubmed:articleTitle |
Cadaveric renal transplantation with quadruple immunosuppression in patients with a positive antiglobulin crossmatch.
|
| pubmed:affiliation |
Department of Surgery, University of Wisconsin School of Medicine, Madison 53792.
|
| pubmed:publicationType |
Journal Article
|