Case Report: A five-year follow up after pediatric renal transplantation using flow cytometry crossmatch and HLA immunophenotyping based on DNA for screening test [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved]

• Published in: F1000 research Vol. 10; p. 352
• Main Authors: Dwi Meiyanto, Johanes, Daryanto, Besut, Penta Seputra, Kurnia
• Format: Journal Article
• Language: English
• Published: London Faculty of 1000 Ltd 2021; F1000 Research Limited; F1000 Research Ltd
• Subjects: Abdomen; Activities of daily living; Antigens; Blood pressure; Case Report; Case reports; Creatinine; Cytotoxicity; Deoxyribonucleic acid; DNA; Flow cytometry; Graft rejection; Hemodialysis; Histocompatibility antigen HLA; Histocompatibility testing; Hospitals; Hydronephrosis; Hypertension; Immunoglobulin M; Kidney diseases; Kidney transplantation; Kidney transplants; Laboratories; Lymphocytes; Medical imaging; Morbidity; Patients; Pediatrics; Peritoneal dialysis; Quality of life; Serum levels; Surgery; Ultrasonic imaging; Urology; Veins & arteries; HLA based on DNA; pediatric renal transplantation; flow cytometry crossmatch
• ISSN: 2046-1402; 2046-1402
• DOI: 10.12688/f1000research.51407.1

Background: There are three methods for renal replacement therapy for end stage chronic kidney disease; dialysis, continuous ambulatory peritoneal dialysis, and renal transplantation which is the best because of the least morbidity rate, the best survival rates, the best quality of life, and the best improvement in activities of daily living. In the field, flow cytometry serves a well-established role in pre- and post-transplant crossmatching, and if it is combined with human leukocyte antigen (HLA) immunophenotyping based on DNA, it will produce a more sensitive prediction of the chronic graft rejection compared to complement-dependent cytotoxicity crossmatching and can eliminate irrelevant antibody (IgM). This is the first experience using this method in our hospital. The survival rate at one, five and ten years has been shown to be 99%, 97% and 96%, respectively; therefore, we wanted to find out the five year follow up of the patient.
Case presentation: We evaluated a 20-year-old female with a history of pediatric renal transplantation five years previously due to end stage renal disease caused by bilateral parenchymatous renal disease. She had a history of hypertension since December 2014 and underwent hemodialysis for three months. The transplantation took place in March 2015. A kidney from her mother was transplanted to recipient using end-to-side anastomoses. After five years, the patient was routinely monitored at the urology clinic, with creatinine serum results between 1.5 and 2 mg/dL, urea and electrolyte serum levels within normal limits and she could resume normal life.
Conclusions: Survival five years after the procedure showed a beneficial outcome of the method used.