Influence of donor specific HLA antibodies detected by Luminex in kidney graft survival: a multivariate analysis

Hum Immunol. 2013 May;74(5):545-9. doi: 10.1016/j.humimm.2013.01.010. Epub 2013 Jan 29.

Abstract

Some studies have demonstrated the clinical relevance of a positive virtual crossmatch in graft survival; nevertheless, other donor and recipient variables influence the outcome of the transplant. The aim of this study was to investigate the relevance of a positive virtual crossmatch in the graft survival performing a multivariate analysis including other pretransplant variables. A total of 879 deceased kidney transplantations were included. Univariate and multivariate analyses were performed using Cox regression model. After performing the multivariate analysis, a positive virtual crossmatch against class I (adjusted HR 6.613; 95% CI 3.222-13.573), class II (adjusted HR 2.419; 95% CI 1.170-5.002) and class I+II (adjusted HR 5.717; 95% CI 1.925-16.975) detected by single antigen Luminex was the variable conferring the greatest relative risk of graft loss. A positive virtual crossmatch predicts a worse kidney graft survival even after correction by other variables and therefore, transplantation of patients with positive virtual crossmatches should be avoided.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antibodies / blood
  • Antibodies / immunology*
  • Female
  • Graft Survival / immunology*
  • HLA Antigens / immunology*
  • Histocompatibility Testing / methods
  • Histocompatibility Testing / statistics & numerical data
  • Humans
  • Immunologic Techniques / methods
  • Kidney / immunology
  • Kidney Transplantation / immunology*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data
  • Proportional Hazards Models
  • Risk Factors
  • Time Factors
  • Tissue Donors*

Substances

  • Antibodies
  • HLA Antigens