RENAL TRANSPLANTATION DESPITE A POSITIVE ANTIGLOBULIN CROSSMATCH WITH AND WITHOUT PROPHYLACTIC OKT3

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Abstract
The antiglobulin crossmatch (AGXM) is a sensitive technique employed by many transplant centers to enhance detection of preformed antibody to donor antigens that may cause hyperacute rejection. However, positive AGXM may detect irrelevant or very low titers of anti-HLA antibody precluding transplantation in suitable recipients. To investigate the significance of a positive AGXM, cadaveric renal transplantation was carried out despite a weakly positive AGXM (defined as cell killing above background but not > 20%) in 48 recipients. In an initial group (n=10), maintained on triple therapy (cyclosporine, azathioprine, and prednisone), accelerated acute rejection occurred in 4 recipients and 3 grafts were lost. A subsequent group (n=38) was treated with a prophylactic course of OKT3 then triple therapy. There were no episodes of accelerated acute rejection (P

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