Abstract
Purpose The presence of donor specific antibodies (DSAs) increases the risk of antibody mediated rejection (AMR) and coronary vasculopathy in heart transplant recipients. Identifying non complement binding DSAs may allow successful transplantation of highly sensitized patients. We analyzed clinical outcomes of adult heart transplant recipients with a positive flow cytometric cross match (FXM) but non complement fixing antibodies as determined by the C1q assay. Methods and Materials Charts of transplant recipients at our institution were reviewed from January 2009 to July 2012 to identify patients with DSAs and a positive FXM and to analyze outcomes. Results Seventy patients were transplanted during this time; five had a positive prospective FXM followed by transplant if their DSA mean fluorescent intensity (MFI) was figure 1 ] Conclusions Differentiating complement and non-complement fixing antibodies using the C1q assay may help in the risk assessment of transplanting a patient with a positive FXM. PreTx PRA (class I/II) # of DSAs # of rejected donors FXM (T/B) AMR Death 1 47/0 1 2 +/- 0 0 2 0/96 2 11 -/+ 0 0 3 100/45 1 1 +/+ n/a YES 4 67/9 2 13 +/+ 0 0 5 98/72 2 12 -/+ 0 0
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