Talbot D
Liver Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK.
Transpl Immunol. 1994 Jun;2(2):138-9. doi: 10.1016/0966-3274(94)90046-9.
When donor class I directed 'warm' antibodies are detected by the conventional cytotoxic crossmatch preoperatively, there is a negative correlation with outcome in renal, liver, cardiac and pancreatic transplantation. When the cytotoxic crossmatch assay is negative and IgG antibodies to T donor lymphocytes are shown to be present in the recipient sera by flow cytometry then there is an increase in postoperative complications in renal transplants. This includes primary nonfunction and treatable rejection which in some cases results in graft failure. Since its introduction into clinical practice for recipient selection in Newcastle, the complication rate of rejection episodes, primary nonfunction and graft failure has been reduced. When applied to other organs there seems to be a definite detrimental association between a positive flow cytometric crossmatch preoperatively and rejection in cardiac transplantation, in some cases leading to death. The role in liver and pancreas transplants to date has not been determined. In the postoperative period there appears to be a limited role for the flow cytometric crossmatch in the detection of antibody prior to the first clinical episode of rejection. This has been applied to renal transplants but to no other organ.
当术前通过传统细胞毒性交叉配型检测到供体I类定向“热”抗体时，在肾、肝、心脏和胰腺移植中，其与移植结果呈负相关。当细胞毒性交叉配型检测为阴性，但通过流式细胞术显示受体血清中存在针对供体T淋巴细胞的IgG抗体时，肾移植术后并发症会增加。这包括原发性无功能和可治疗的排斥反应，在某些情况下会导致移植失败。自从在纽卡斯尔将其引入临床实践用于受体选择以来，排斥反应、原发性无功能和移植失败的并发症发生率已经降低。当应用于其他器官时，术前流式细胞术交叉配型阳性与心脏移植排斥之间似乎存在明确的有害关联，在某些情况下会导致死亡。迄今为止，其在肝移植和胰腺移植中的作用尚未确定。在术后阶段，流式细胞术交叉配型在首次临床排斥发作前检测抗体方面的作用似乎有限。这已应用于肾移植，但未应用于其他器官。
