Anti-HLA donor-specific antibodies detected in positive B-cell crossmatches by Luminex (R) predict late graft loss

The significance of B-cell crossmatching in kidney transplantation is controversial. Recipients (n = 471) transplanted in a single centre from 1987 to 2005 with complete T- and B-cell crossmatch records were studied. Sera from 83 patients transplanted across a positive B-cell crossmatch, with concomitant negative T-cell crossmatch (T–B+) on either current and/or peak sera were studied using Luminex® to determine presence of donor-specific antibodies (DSA). Clinical outcomes of T–B+ patients were compared with 386 T–B− patients. T–B+ predicted vascular (p = 0.01), but not cellular (p = 0.82) or glomerular (p = 0.14) rejection. IgG HLA DSA were found in 33% (n = 27) of the T–B+ patients and were associated with higher risk of any (p = 0.047), vascular (p = 0.01) or glomerular (p 60% of patients in whom BXM is not indicative of the presence of DSA.H. S. Eng, G. Bennett, E. Tsiopelas, M. Lake, I. Humphreys, S. H. Chang, P. T. H. Coates and G. R. Rus