Advancements in Positive Crossmatch Renal Transplantation Three Year Outcomes After Desensitization

Introduction Renal transplantation remains the gold standard for treating end-stage renal disease (ESRD), offering superior survival benefits compared to dialysis. However, patients with a positive crossmatch (PXM) face significant challenges due to donor-specific antibodies (DSA), increasing the risk of rejection. Recent advancements in desensitization protocols have enabled successful kidney transplants in sensitized patients. A study published in the Journal of Clinical Nephrology evaluated three-year outcomes in PXM transplant recipients who failed to convert to a negative flow cytometric crossmatch (FCXM) after desensitization. Visit HSPIOA for more groundbreaking research in nephrology.

Study Overview: Improved Outcomes Despite Persistent Crossmatch Positivity

• Objective: Assess long-term renal function, rejection rates, and survival in kidney transplant recipients with persistent positive FCXM post-desensitization.
• Participants: 108 desensitized patients between 2000 and 2011 at UI Health, categorized into:
  • Not Converted Group (n=42) Persistent positive FCXM before transplant.
  • Converted Group (n=66): Successfully converted to negative FCXM.
• Findings:
  • Three-year estimated glomerular filtration rate (eGFR) was comparable (57.8 mL/min vs. 57.1 mL/min, p=0.91).
  • Biopsy-proven rejection rates were higher in the not converted group but not statistically significant.
  • Patient survival at three years remained high (95% vs. 91%).

Clinical Implications and Future Directions Despite higher rejection rates, patients in the not converted group demonstrated similar long-term graft function and survival benefits, emphasizing the viability of transplantation even in borderline crossmatch cases. The American College of Radiology (ACR) highlights the importance of ensuring equitable access to transplantation while maintaining high care standards.

Linking to Key Resources For a deeper dive into the study findings, access the full article at https://doi.org/10.29328/journal.jcn.1001016. Explore related transplant studies on our platform to stay updated on the latest advancements in nephrology.

Conclusion: Expanding Opportunities for Sensitized Patients This study reinforces the potential of desensitization to bridge the gap for sensitized patients facing long wait times for compatible donors. With continued improvements, positive crossmatch transplantation may become more widely adopted as a viable option.

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