@article {Haririan:March 2009:1600-6135:536,
	author = "Haririan, A.",
	author = "Nogueira, J.",
	author = "Kukuruga, D.",
	author = "Schweitzer, E.",
	author = "Hess, J.",
	author = "Gurk-Turner, C.",
	author = "Jacobs, S.",
	author = "Drachenberg, C.",
	author = "Bartlett, S.",
	author = "Cooper, M.",
	title = "Positive Cross-Match Living Donor Kidney Transplantation: Longer-Term Outcomes",
	journal = "American Journal of Transplantation",
	volume = "9",
	year = "March 2009",
	abstract = "<B>The long-term graft outcomes after positive cross-match (PXM) living donor kidney transplantation (LDKT) are unknown and the descriptive published data present short-medium term results. We conducted a retrospective cohort study of LDKT with PXM by flow cytometry performed at our center during February 1999 to October 2006, compared to a control group, matched 1:1 for age, sex, race, retransplantation and transplant year. The PXM group was treated with a course of plasmapheresis/low-dose intravenous immunoglobulin (IVIg) preoperatively, and OKT3 or thymoglobulin induction.</B> <P></P><B>Both groups (n &#61; 41 each) were comparable except for duration of end-stage renal disease (ESRD), induction, HLA mismatch and panel-reactive antibody (PRA). During the period of up to 9 years, 14 PXM and 7 controls lost their grafts (p &#60; 0.04). Graft survival rates at 1 and 5 years were 89.9&#37; and 69.4&#37; for PXM group and 97.6&#37; and 80.6&#37; for the controls, respectively. PXM was associated with higher risk of graft loss (HR 2.6, p &#61; 0.04; 95&#37;CI 1.03-6.4) (t<SUB>1/2</SUB>&#61; 6.8 years), but not with patient survival (HR 1.96, p &#61; 0.29; 95&#37;CI 0.6-7.0) or 1-year serum creatinine (&#946;&#61; 0.06, p &#61; 0.59 for ln (SCr); 95&#37; CI &#8722;0.16 to 0.28).</B> <P></P><B>These results suggest that despite the favorable short-term results of PXM LDKT after PP/IVIg conditioning, medium-long-term outcomes are notably worse than expected, perhaps comparable to non-ECD deceased donor kidney transplantation (KT).</B>",
	pages = "536-542(7)",
	url = "http://www.ingentaconnect.com/content/mksg/ajt/2009/00000009/00000003/art00012"
	doi = "doi:10.1111/j.1600-6143.2008.02524.x"
}