Outcomes in Simultaneous Liver Kidney Transplants in the Setting of a Positive Crossmatch : A Single Center Experience
Copyright© 2017 by the Terasaki Research Institute..
Recent literature suggests that a positive crossmatch adversely impacts outcomes in simultaneous liver-kidney transplant (SLKT). The aim of this study was to evaluate outcomes of SLKT with a positive flow crossmatch (+FCXM) at our center. We retrospectively analyzed all of the SLKTs between January 1, 2000, and September 30, 2010. A total of 2793 kidney transplants and 892 liver transplants were performed in this time period, of which, 31 were SLKT (3%). Seven of the 31 (22%) SLKTs had a +FCXM. There were 3 major adverse events: 1 patient mortality at 9 months with liver failure; 1 allograft nephrectomy for primary nonfunction secondary to hyper-acute rejection; and, 1 recurrent liver allograft rejection with eventual graft loss and death at 26 months post-transplant. The median follow-up time was 34 months. The 3-year overall SLKT patient survival in the negative FCXM (-FCXM) patients was 85% compared with 71% in the +FCXM group. The rates of acute liver and kidney rejection were 6% and 10%, respectively, in the -FCXM group compared to 14% and 28%, respectively, in the +FCXM group. A very strongly +FCXM with a mean channel shift above 4 times the positive cut-off and the presence of multiple strong donor-specific antibodies (DSA) with mean fluorescence intensity (MFI) above 10,000 were associated with poorer outcome. In conclusion, in patients with very strongly +FCXM with high MFI DSA, proceeding with the transplantation leads to poor outcomes.
| Medienart: |
Artikel |
|---|
| Erscheinungsjahr: |
2016 |
|---|---|
| Erschienen: |
2016 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:32 |
|---|---|
| Enthalten in: |
Clinical transplants - 32(2016) vom: 25., Seite 119-125 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Ong, Song C [VerfasserIn] |
|---|
| Themen: |
Donor-specific antibodies |
|---|
| Anmerkungen: |
Date Completed 23.07.2018 Date Revised 02.12.2018 published: Print Citation Status MEDLINE |
|---|
| Förderinstitution / Projekttitel: |
|
|---|
| PPN (Katalog-ID): |
NLM272452394 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM272452394 | ||
| 003 | DE-627 | ||
| 005 | 20231224234908.0 | ||
| 007 | tu | ||
| 008 | 231224s2016 xx ||||| 00| ||eng c | ||
| 028 | 5 | 2 | |a pubmed24n0908.xml |
| 035 | |a (DE-627)NLM272452394 | ||
| 035 | |a (NLM)28564529 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Ong, Song C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Outcomes in Simultaneous Liver Kidney Transplants in the Setting of a Positive Crossmatch |b A Single Center Experience |
| 264 | 1 | |c 2016 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a Date Completed 23.07.2018 | ||
| 500 | |a Date Revised 02.12.2018 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright© 2017 by the Terasaki Research Institute. | ||
| 520 | |a Recent literature suggests that a positive crossmatch adversely impacts outcomes in simultaneous liver-kidney transplant (SLKT). The aim of this study was to evaluate outcomes of SLKT with a positive flow crossmatch (+FCXM) at our center. We retrospectively analyzed all of the SLKTs between January 1, 2000, and September 30, 2010. A total of 2793 kidney transplants and 892 liver transplants were performed in this time period, of which, 31 were SLKT (3%). Seven of the 31 (22%) SLKTs had a +FCXM. There were 3 major adverse events: 1 patient mortality at 9 months with liver failure; 1 allograft nephrectomy for primary nonfunction secondary to hyper-acute rejection; and, 1 recurrent liver allograft rejection with eventual graft loss and death at 26 months post-transplant. The median follow-up time was 34 months. The 3-year overall SLKT patient survival in the negative FCXM (-FCXM) patients was 85% compared with 71% in the +FCXM group. The rates of acute liver and kidney rejection were 6% and 10%, respectively, in the -FCXM group compared to 14% and 28%, respectively, in the +FCXM group. A very strongly +FCXM with a mean channel shift above 4 times the positive cut-off and the presence of multiple strong donor-specific antibodies (DSA) with mean fluorescence intensity (MFI) above 10,000 were associated with poorer outcome. In conclusion, in patients with very strongly +FCXM with high MFI DSA, proceeding with the transplantation leads to poor outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a donor-specific antibodies | |
| 650 | 4 | |a flow crossmatch | |
| 650 | 4 | |a kidney transplant | |
| 650 | 4 | |a liver transplant | |
| 650 | 4 | |a transplantation | |
| 700 | 1 | |a White, Jared |e verfasserin |4 aut | |
| 700 | 1 | |a Hauptfeld-Dolejsek, Vera |e verfasserin |4 aut | |
| 700 | 1 | |a Kumar, Vineeta |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical transplants |d 1989 |g 32(2016) vom: 25., Seite 119-125 |w (DE-627)NLM012654752 |x 0890-9016 |7 nnns |
| 773 | 1 | 8 | |g volume:32 |g year:2016 |g day:25 |g pages:119-125 |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 32 |j 2016 |b 25 |h 119-125 | ||