Kidney Week

Abstract: SA-PO059

Use of Virtual Crossmatch Exclusively to Allocate Deceased Donor Kidney Transplant

Session Information

• Transplantation: Recipient and Donor Assessment
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Abuhelaiqa, Essa, Hamad Medical Corporation, Doha, Qatar

Essa Abuhelaiqa,

• Thappy, Shaefiq Babu, Hamad Medical Corporation, Doha, Qatar

Shaefiq Babu Thappy,

• Alkadi, Mohamad M., Hamad Medical Corporation, Doha, Qatar

Mohamad M. Alkadi,

• Mahmoud, Jehan, Hamad Medical Corporation, DOHA, Qatar

Jehan Mahmoud,

• Jarman, Mona, Hamad Medical Corporation, DOHA, Qatar

Mona Jarman,

• Nauman, Awais, Hamad Medical Corporation, Doha, Qatar

Awais Nauman,

• Asim, Muhammad, Hamad Medical Corporation, Doha, Qatar

Muhammad Asim,

• Fituri, Omar, Hamad Medical Corporation, Doha, Qatar

Omar Fituri,

• Al-Malki, Hassan A., Hamad Medical Corporation, Doha, Qatar

Hassan A. Al-Malki,

Background

Virtual crossmatch (VXM) using Luminex single antigen bead has significantly improved prediction of a negative crossmatch due to its high sensitivity. An actual pretransplant lymphocyte crossmatch such as complement dependent cytotoxicity crossmatch (CDCXM) or flow cytometry crossmatch (FCXM) is typically required; however, it may delay deceased donor renal transplantation (DDRT) and possibly affect allograft outcomes. We evaluated the safety of only using VXM pretransplant without waiting for actual crossmatch to allocate DDRT.

Methods

In our center, we have initiated a protocol to allocate kidneys from brain-dead deceased donors based on VXM since 2015. 46 DDRT were performed at our center between 2010 to 2017. 21 (45%) recipients only underwent pretransplant VXM, and all were found to have a negative FCXM retrospectively. We evaluated the effect of this protocol on cold ischemia time (CIT), delayed graft function (DGF), acute rejection (AR) within first year post transplant, and graft survival.

Results

There was a significant reduction of CIT by more than 6 hours (P=0.001) when FCXM was not done prospectively prior to transplant. 3 out of 25 (12%) patients with prospective FCXM had DGF, while no DGF was observed in retrospective FCXM (P=0.2). AR within first year occurred in 4% of prospective vs. 5% retrospective FCXM. 1-year and 3-year graft survival rates were 96% vs. 100% and 92% vs. 88%, in prospective vs. retrospective FCXM, respectively.

Conclusion

Use of pretransplant VXM exclusively for final DDRT allocation decision reduces duration of CIT and may reduce incidence of DGF without increasing risk of AR or affecting graft survival