Table 3.

Patients with severe graft dysfunctiona

Patient No.bPre-RTX CDC-PRA (%)≥5% Pre-RTX FlowPRAPre-RTX FCXMBanff GradeC4d (PTC)Post-RTX FCXMAnti-Donor HLA Ab Identified after RTXcGraft Loss
a RTX, renal transplantation; CDC-PRA, lymphocytotoxic panel-reactive antibody reactivity; T, positive T cell FCXM; Ab, antibodies; B, positive B cell FCXM; Neg, negative; Pos, positive.
b Six of seven patients were female (previous pregnancies for three recipients).
c Antibodies against mismatched donor HLA antigens were assessed by using the FlowPRA specific HLA class I or II antibody test, as detailed in Materials and Methods.
d Patient 1 had received a third allograft and the other six recipients a first kidney allograft.
e For patients 6 and 7, severe graft dysfunction (dialysis dependence at the time of rejection) was successfully reversed with IA and antithymocyte globulin therapy.
1d58YesT + BIIIPosT + BYes (DR52)Yes
28YesT + BIIIPosT + BNoYes
30NoNegIIPosNegNoYes
48NoNegIPosTNoYes
50NoNegIINegTNoYes
60YesTIIPosT + BYes (A3, Bw6)Noe
70YesNegIIIPosBYes (DR1, DR10)Noe