Flow Cytometry Monitoring of Donor Specifi c Antibodies after Kidney Transplantation

OBJECTIVE: In this study, we purpose that the screening of posttransplant donor spesifi c antibodies
(DSA) and target of these antibodies by fl ow-cytometry. We also try to investigate that the relationship
with the DSA’s and the graft survival.
 

MATERIAL and METHODS: Fifty renal transplant patients and their related donors were included
to study. Serum samples were taken 1., 7.,14. days and 1., 3., 6 and 12. posttransplant months. T and B
cell fl ow cytometric cross-match tests were performed with the donor derived fresh cells.
 

RESULTS: We determined as positive FCXM results of postransplant 1., 7., 14. days as 16%, and
1., 6., 9. and 12. months 18%, 14%, 12% and 12% respectively. While 5 patients results are positive
in whole study time, 6 patients results were positive different test days. Two of fi ve patients who had
whole study days FCXM positive lost their allografts due to acute rejection episodes in posttransplant
secod and third day. Chronic allograft dysfuntion was occured in three of 6 patients who had FCXM positive (B cell FCXM positive) in the different day. Two patients lost their grafts during the study period. Graft survival was found 96% and 96%
in 6 and 12 months respectively. There was a relationship between the test days creatinine levels and FCXM results.
 

CONCLUSION: As a result; while positive results of B and T cell FCXM in whole study days are related with the acute rejection and graft survival
but there is no relationship with chronic rejection. It was also found that no relationship between the only T cell positive FCXM and acute rejection,
graft survival and chronic rejection. In the fi rst posttransplant month, the relationship between positive B cell FCXM tests and chronic rejection
were found statistically signifi cant. It is shown that the posttransplant B and T cell FCXM and fi rst month B cell FCXM tests are predictive for acute
rejection, graft survival and chronic rejection respectively. Permanent and intermittent FCXM positivity were not found related with acute rejection
and graft survival. The creatinine levels of patients with FCXM positivity were found to be higher than the patients with FCXM negative.