Bittencourt M C, Rebibou J M, Saint-Hillier Y, Chabod J, Dupont I, Chalopin J M, Herve P, Tiberghien P
ETS de Franche-Comté, Laboratoire d'Histocompatibilité et Thérapeutique Immunomoléculaire, Besançon, France.
Nephrol Dial Transplant. 1998 Aug;13(8):2059-64. doi: 10.1093/ndt/13.8.2059.
The clinical and immunological relevance of a positive B-cell flow-cytometry (B-FCXM) crossmatch in renal transplantation is still controversial.
We retrospectively analysed 145 consecutive cadaveric renal transplantations performed from May 1991 to September 1995 in our institution. All grafts were transplanted following a negative IgG T-cell complement-dependent cytotoxicity crossmatch (T-CDCXM). Concomitantly to CDCXM, B-cell and T-cell FCXM were performed and results were expressed as a mean fluorescence index (FI). Two groups were compared: 116 recipients grafted with a negative B-FCXM vs a group of 19 patients grafted with a positive B-FCXM.
The two groups were similar for length of cold ischaemia, donor and recipient's age and degree of HLA mismatching. The proportion of patients with pre-transplant anti-HLA class I antibodies or a retransplantation was significantly increased in the positive B-FCXM group vs the negative B-FCXM group. Recipient survival at 48 months was not significantly different in the two groups. However, graft survival at 12 and 48 months was significantly poorer in the positive B-FCXM than in negative B-FCXM (68% vs 90% at 12 months: P = 0.007, and 57% vs 79% at 48 months: P = 0.02). Within the positive B-FCXM group, no differences were found in pre-transplant anti-HLA class I or II alloimmunization as well as retransplantation frequency between the patients who lost their graft and the patients who did not.
Our results suggest that a pretransplant positive B-FCXM is associated with an impaired long-term graft survival in renal allotransplantation.
肾移植中B细胞流式细胞术（B-FCXM）交叉配型阳性的临床及免疫学相关性仍存在争议。
我们回顾性分析了1991年5月至1995年9月在我院连续进行的145例尸体肾移植。所有移植物均在IgG T细胞补体依赖细胞毒性交叉配型（T-CDCXM）阴性后进行移植。在进行CDCXM的同时，进行B细胞和T细胞FCXM，结果以平均荧光指数（FI）表示。比较两组：116例接受B-FCXM阴性移植的受者与19例接受B-FCXM阳性移植的患者。
两组在冷缺血时间、供受者年龄及HLA错配程度方面相似。与B-FCXM阴性组相比，B-FCXM阳性组移植前抗HLA I类抗体或再次移植患者的比例显著增加。两组48个月时受者生存率无显著差异。然而，B-FCXM阳性组12个月和48个月时的移植物生存率显著低于B-FCXM阴性组（12个月时分别为68%对90%：P = 0.007，48个月时分别为57%对79%：P = 0.02）。在B-FCXM阳性组中，移植物丢失患者与未丢失患者在移植前抗HLA I类或II类同种免疫以及再次移植频率方面未发现差异。
我们的结果表明，移植前B-FCXM阳性与肾同种异体移植中长期移植物存活率受损有关。
