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Systemic Lupus Erythematosus Leading to Terminal Renal Failure and Excluding Patients from Kidney Allocation Due to Inadequate CDC-based Cross-Matching: Is There a Diagnostic Way out?
Author(s): Gerald Schlaf, Anita Rothhoff and Wolfgang W. AltermannGerald Schlaf, Anita Rothhoff and Wolfgang W. Altermann
Systemic lupus erythematosus (SLE) is known to proceed to clinically relevant nephritis in more than 50% of patients and, in about 20% of these patients, to terminal renal failure. Thus, renal replacement therapy including kidney allografting is required for a considerable number of SLE-patients. For allografting patients’ donor-specific antibodies against HLA molecules of given donors (DSA) have to be excluded as preformed antibodies against these molecules represent the main cause for hyper-acute or acute rejections. In order to select recipients without these deleterious antibodies the complement-dependent cytotoxicity crossmatch (CDC-XM) assay was developed about forty years ago. Its negative pre-transplant outcome is currently regarded as the most important requirement for a successful kidney graft survival. During the last years several disadvantages of the CDC-based proce.. View More»