Cadaveric renal transplant in the highly sensitized African-American patient.

Publication/Presentation Date

8-1-1993

Abstract

A statistically significant difference was discovered when comparing the 1-year graft survival of CAUC and AA. The difference was due in part to nine AA failures that occurred within the first week posttransplant (Fig 3). Using a multivariant analysis both the AA and CAUC were found to be normally distributed in regard to CIT, HLA mismatch, transplant number, and PRA. If these traditional variables thought to have relevance on graft survival in cadaveric renal transplantation are ruled out as contributing factors other avenues must be explored. If credence is given to the theory that the difference in function between AA and CAUC is due to the difference in the number of transplants that failed within the first week then factors such as immunosuppressive therapy and noncompliance can also be ruled out. One possible area of explanation may lie in the area of specificity to HLA antibody. It is possible that these recipients received transplants from a donor to which they were sensitized. A closer analysis of donor and recipient HLA typing as well as the recipient's transfusion and transplant history is recommended. Despite the fact that all transplants occurred in the presence of negative preliminary and final XM's using American Society for Histocompatibility and Immunogenetics (ASHI) certified techniques (Table 2), transplant centers may wish to consider using a more sensitive XM technique such as flow cytometry for these patients. We hope that these recommendations will enable transplant centers to continue their commitment to transplanting the highly sensitized recipient.

Volume

25

Issue

4

First Page

2479

Last Page

2480

ISSN

0041-1345

Disciplines

Medicine and Health Sciences

PubMedID

8356639

Department(s)

Department of Surgery

Document Type

Article

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