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Table. 2.

Table. 2.

XM results and associated data in 13 patients with pretransplant positive XM results in the absence of DSAs

Patient. Sex/age CDC T/B-FCXM HLA Ab (l/ll) Non-HLA Abs Sensitization Hx TP Duration of follow up (month) Clinical course
1 F/43 N/N/N* N/P (1.4) P/P VM (2,388), REG3A (151) Pregnancy LDKT 21 Stable
2 F/48 N/N/N P(1.3)/P(1.7) P/N PRKCH (2,825), CXCL11 (400), IFNG (584), REG3A (310), Collagen II (453) Pregnancy LDKT 15 Rejection (5 months post-KT)§
3 F/54 N/N/N N/P(2.8) N/N AT1R, VM (1267), GSTT1 (12,718), PRKCH (2,319), IFNG (955), REG3A (126) Transfusion LDKT 9 Stable
4 M/58 N/N/P(1:4) P(5.9)/P(4.6) N/P ENO1 (4,710), PRKCH (1279), CXCL11 (393), CXCL10 (375), IFNG (816), REG3A (571), GAPDH (1363), Collagen III (253) Transfusion LDKT 7 Stable
5 M/45 N/N/N P(5.1)/P(4.6) P/N REG3A (101) - LDKT 6 Stable
6 M/50 N/N/N N/P(3.0) P/N PRKCH (2,914), REG3A (125) - LDKT 5 Not done
7** M/61 P(1:1)/P(1:2)/P(1:2) P(2.1)/P(5.2) N/N VM (1,070), GSTT1 (6,594), PECR (5,035), PRKCH (1491), LMNB (2,851), REG3A (865), GAPDH (836) - LDKT 4 Rejection episode (1 month post-KT)
8 M/66 N/N/N P(5.0)/N N/N ENO1 (6,704), FLRT2 (4,665), VM (9,890), TUBA1B (4,802), CD36 (3,074), IFIH1 (6,991), AGT (10,139), AURKA (4,995), PPIA (7,882), GSTT1 (8,373), LMNA (8,198), PECR (5,503), PRKCH (5,931), LMNB (6,927), CXCL11 (406), CXCL10 (328), HNRNPK (1274), IFNG (724), REG3A (417), Collagen III (152), Collagen IV (74) Transfusion LDLT 8 Stable
9 M/67 N/N/N N/P(3.4) N/N ENO1 (13,482), PECR (6,876), PRKCH (1204), REG3A (265), Collagen III (167), Collagen IV (48) Transfusion LDLT 5 Stable
10 M/56 N/N/N N/P(3.2) N/P ENO1 (5,236), IFIH1 (12,009), PTPRN (3,377), PRKCH (1511), CXCL11 (338), CXCL10 (360), HNRNPK (1,136), IFNG (897), REG3A (311) Transfusion LDLT 12 Stable
11 M/64 N/N/P(1:4) N/N N/P FLRT2 (5,684), VM (9,281), TUBA1B (4,086), CD36 (4,163), IFIH1 (4,386), AGT (6,010), PTPRN (4,800), PPIA (5,209), LMNA (8,295), PRKCH (1602), LMNB (6,397), CXCL10 (506), HNRNPK (1670), IFNG (618), REG3A (253), GAPDH (2,454) - LDLT 10 Stable
12 M/32 N/N/P(1:2) P(3.7)/P(1.7) P/P AT1R, ENO1 (4,635), FLRT2 (2,209), VM (7,134), TUBA1B (2,695), Myosin (9,554), AGT (5,915), PPIA (4,187), PRKCH (7,632), LMNB (3,143), HNRNPK (1824), IFNG (797), REG3A (553), GAPDH (1445), Collagen I (592), Collagen III (404) Transfusion LDLT 10 Stable
13 F/17 N/N/N N/P(2.2) N/N FLRT2 (749), VM (1849), CXCL10 (378), REG3A (207) - LDKT 7 NA

*T-CDC, T-AHG, B-CDC in order (highest titer value in positive CDC is given in parenthesis). T-FCXM, B-FCXM in order (MFI given in parenthesis). MFI value of raw trimmed mean minus negative control bead [reference background values of lower 95% non-transplant population; ENO1 (4,218), FLRT2 (688), VM (820), TUBA1B (1987), CD36 (1591), IFIH1 (3,870), MYOSIN (9,341), AGT (1641), PTPRN (3,042), AURKA (4,892), CHAF1B (11,722), PPIA(3,292), EIF2A (6,901), GSTT1 (6,136), LMNA (6,633), PRKCZ (9,104), PECR (4,120), PRKCH (1,048), LMNB (2065), CXCL11 (309), CXCL10 (285), CXCL9 (575), AGRIN (504), ARHGDIB (3,918), GDNF (1,004), HNRNPK (845), IFNG (498), NCL (3,669), REG3A (86), GAPDH (508), TNFA (5,331), PLA2R (195), LG3 (3,801), Collagen I (375), Collagen II (155), Collagen III (128), Collagen IV (71), Collagen V (187), Fibronectin (141)]. §Non-HLA antibodies at the time of rejection; PRKCH (1298), REG3A (162), Collagen II (161). Non-HLA antibodies at the time of rejection; VM (1595), AGT (1739), PPIA (3,434), PECR (4,684), PRKCH (1955), IFNG (662), REG3A (510). Patient 2 developed biopsy-confirmed T cell-mediated rejection at five months post-KT. **Patient 7 presented with an elevated creatinine level one month post-KT; subsequent biopsy revealed C4d deposition with acute tubular necrosis.

Abbreviations: XM, crossmatch; M, Male; F, Female; DSAs, donor-specific antibodies; CDC, complement-dependent cytotoxicity; FCXM, flow cytometry crossmatch; HLA, human leukocyte antigen; Ab, antibody; Hx, history; TP, transplantation; N, negative; P, positive; MFI, mean fluorescent intensity; VM, vimentin; REG3A, regenerating islet-derived protein 3-alpha; LDKT, living donor kidney transplantation; PRKCH, protein kinase C eta type; CXCL11, C-X-C motif chemokine 11; IFNG, interferon gamma; AT1R, angiotensin II type 1 receptor; GSTT1, glutathione S-transferase theta-1; ENO1, alpha-enolase; CXCL10, C-X-C motif chemokine 10; GAPDH, glyceraldehyde-3-phosphate dehydrogenase; KT, kidney transplantation; PECR, peroxisomal trans-2-enoyl-CoA reductase; PTPRN, receptor-type tyrosine-protein phosphatase-like N; LMNB, lamin-B1; FLRT2, leucine-rich repeat transmembrane protein; TUBA1B, tubulin alpha-1B chain; IFIH1, interferon-induced helicase C domain-containing protein 1; AGT, angiotensinogen; AURKA, aurora kinase A-interacting protein; PPIA, peptidyl-prolyl cis-trans isomerase A; LMNA, prelamin-A/C; HNRNPK, heterogeneous nuclear ribonucleoprotein K; LDLT, living donor liver transplantation; NA, not applicable; AHG, anti-human globulin antibody; CHAF1B, chromatin assembly factor 1 subunit B; EIF2A, eukaryotic translation initiation factor 2A; PRKCZ, protein kinase C zeta; ARHGDIB, Rho GDP dissociation inhibitor beta; GDNF, glial cell line-derived neurotrophic factor; NCL, nucleolin; TNFA, tumor necrosis factor alpha; PLA2R, phospholipase A2 receptor.

Ann Lab Med 2021;41:429~435 https://doi.org/10.3343/alm.2021.41.4.429

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