Background and Objectives
Despite the obvious survival benefit compared to that among waitlisted patients, the outcomes of positive crossmatch kidney transplantation (KT) are generally inferior to those of human leukocyte antigen (HLA)- compatible KT.
This study aimed at comparing the outcomes of positive complement-dependent cytotoxicity (CDC) crossmatch (CDC+FC+) and positive flow cytometric crossmatch (CDC-FC+) with those of HLA-compatible KT (CDC-FC-) after successful desensitization.
Methodology
This retrospective study was carried out using the methodology outlined in Table 1.
Key Results
Graft and patient survival
Survival outcomes in the two groups as depicted in Table 2.
Survivorship outcomes have been depicted in Figure 1.
Graft function
Graft function was assessed on the basis of median estimated glomerular filtration rates (eGFR) at 5 years follow-up as mentioned in Table 3.
CDC+FC+ versus CDC-FC- was independently associated with eGFR at 6 months (β=−8.18, p<0.001) and that at 2 years (β=−5.85, p=0.020).
Biopsy-proven acute rejection (BPAR) within 1 year after transplantation
Results pertaining to BPAR have been summarized in Table 4.
Infectious complications within 1 year after transplantation
No patient died from posttransplant infection within 1 year.
Conclusion
This study showed that similar graft and patient survival was achieved in CDC-FC+ and CDC+FC+ KT compared with CDC-FC- through DSA-targeted desensitization despite the higher incidence of rejection and infection than that in compatible KT.
