{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T12:41:46Z","timestamp":1758631306744,"version":"3.41.2"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,4,6]],"date-time":"2019-04-06T00:00:00Z","timestamp":1554508800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Crossmatching (XM) between organ donors and recipients is correlated with clinical outcomes. This study evaluates the results of HLA\u2010incompatible kidney transplant (HLA\u2010i KT) according to pre\u2010transplant XM modalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included 731 consecutive patients. HLA\u2010i KT was defined as a transplant under conditions of complement\u2010dependent cytotoxicity (CDC) XM positivity, flow\u2010cytometric XM (FCXM) positivity, and\/or maximal donor\u2010specific antibody (DSA) mean fluorescence intensity (MFI) \u22655000.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of antibody\u2010mediated rejection (AMR) within 1\u00a0year after transplant was significantly higher in the HLA\u2010i group than in the HLA compatible (HLA\u2010c) group (15 vs 9 patients, 14.2% vs 1.4%; <jats:italic>P\u00a0&lt;\u00a0<\/jats:italic>0.01). Multivariate analysis indicated that a DSA MFI \u22655000 (odds ratio [OR]\u00a0=\u00a02.63; 95% confidence interval [CI], 1.00\u20106.98; <jats:italic>P\u00a0=\u00a0<\/jats:italic>0.05) was significantly associated with acute rejection (AR), whereas CDC (OR\u00a0=\u00a02.09; 95% CI, 0.55\u20107.99; <jats:italic>P\u00a0=\u00a0<\/jats:italic>0.28) and FCXM positivity (OR\u00a0=\u00a02.07; 95% CI, 0.73\u20105.87; <jats:italic>P\u00a0=\u00a0<\/jats:italic>0.17) were not. Similarly, DSA MFI\u00a0\u2265\u00a05000 (OR\u00a0=\u00a04.14; <jats:italic>P\u00a0=\u00a0<\/jats:italic>0.02) was the only significant factor affecting the risk of AMR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Of the various XM tests, DSA MFI \u22655000 was the most prominent predictor of AR in patients undergoing HLA\u2010i KT.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.13533","type":"journal-article","created":{"date-parts":[[2019,3,13]],"date-time":"2019-03-13T06:44:57Z","timestamp":1552459497000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The results of HLA\u2010incompatible kidney transplantation according to pre\u2010transplant crossmatch tests: Donor\u2010specific antibody as a prominent predictor of acute rejection"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5018-5304","authenticated-orcid":false,"given":"Hyunwook","family":"Kwon","sequence":"first","affiliation":[{"name":"Division of Kidney &amp; Pancreas Transplantation, Department of Surgery, Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Hoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Kidney &amp; Pancreas Transplantation, Department of Surgery, Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1469-953X","authenticated-orcid":false,"given":"Jee Yeon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Kidney &amp; Pancreas Transplantation, Department of Surgery, Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji Yoon","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Kidney &amp; Pancreas Transplantation, Department of Surgery, Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung","family":"Shin","sequence":"additional","affiliation":[{"name":"Division of Kidney &amp; Pancreas Transplantation, Department of Surgery, Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joo Hee","family":"Jung","sequence":"additional","affiliation":[{"name":"Division of Kidney &amp; Pancreas Transplantation, Department of Surgery, Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su\u2010Kil","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0990-6824","authenticated-orcid":false,"given":"Duck Jong","family":"Han","sequence":"additional","affiliation":[{"name":"Division of Kidney &amp; Pancreas Transplantation, Department of Surgery, Asan Medical Center University of Ulsan College of Medicine Seoul 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