Outcome of renal transplantation following a positive cross-match with historical sera: the ASHI survey.

Analysis of retrospective data, obtained on 216 patients from 27 centers transplanted across some form of positive lymphocyte cross-match in a noncurrent serum, revealed that actuarial 1-yr graft survival was 69% in first transplants and 53% in recipients of second or subsequent transplants. Graft outcome did not correlate with peak antibody levels, change in antibody from peak to current, remoteness in time of the most recent positive serum, the number or timing of sera cross-matched, the technique or target cell cross-matched, or the degree of positivity of the most recent positive serum. Although a concurrent control population was not available, these results support the concept that acceptable graft survival can be achieved despite a positive cross-match with noncurrent sera.