Renal transplantation performed across a positive crossmatch: A single centre experience.
Leavey, S. F. 1; Walshe, J. J. 1; O'Neill, D. 1; Atkins, N. 1; Donohoe, J. 1; Hickey, D. 3; Carmody, M. 1
[Article] Irish Journal of Medical Science. 166(4):245-248, October/November/December 1997.

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: The importance of certain positive crossmatches (CM ) in kidney transplantation remains controversial. Fifty consecutive kidney transplants were performed across a CM between Jan. 1990 - April 1994. In 19 cases there was an isolated B-cell CM (Group I), in 24 an historic T-cell IgM CM (Group II) and in 7 an historic T-cell IgG CM (Group III). Comparing groups I:II:III: early acute rejection affected 32%, 42%, 57% of grafts; mean serum creatinine at 3 months was 166, 150, 229 umol/l (p<0.05); 1 yr graft survival was 95 per cent, 96 per cent, 71 per cent (p=0.09). In group III both graft losses were in the setting of an additional current B-cell CM . Conclusions: Transplantation performed in either the presence of an isolated B-cell CM or in the presence of an historic T-cell IgM CM was associated with acceptable outcomes at 1 yr. An historic T-cell IgG CM was confirmed as a contraindication to transplantation in most circumstances, especially when coupled with a current B-cell CM .

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