Clinical Implications of Pre-Transplantation Panel Reactive Antibody in Renal Transplantation in Koreans.
- Author:
Min Young KIM
1
;
Seong Hoon KIM
;
Jongwon HA
;
Jung Kee CHUNG
;
Curie AHN
;
Myoung Hee PARK
;
Sang Joon KIM
Author Information
1. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. sjkimgs@plaza.snu.ac.kr
- Publication Type:Original Article
- Keywords:
Renal transplantation;
Complement dependent cytotoxicity (CDC);
Panel reactive antibody (PRA);
Survival;
Prognostic factor;
Korean
- MeSH:
Cadaver;
Female;
Graft Survival;
Humans;
Kidney Transplantation*;
Lymphocytes;
Male;
Mass Screening;
Multivariate Analysis;
Tissue Donors;
Transplantation;
Transplants
- From:The Journal of the Korean Society for Transplantation
2002;16(1):47-56
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Panel reactive antibody (PRA) is a screening test for HLA alloimmunization. The purpose of this study is to clarify the clinical implications of pre-transplantation PRA in renal transplantation in Koreans. METHODS: Study subjects included 99 renal transplant recipients whose HLA cross match tests were conducted between Jan. 1994 and Dec. 1995. Their sera were tested for PRA using 50 lymphocyte panels from Koreans by NIH and AHG methods. RESULTS: PRA was positive in 18 (18%) patients by NIH method, and in 19 (19%) patients by AHG method. NIH PRA positivity was higher in the female group (33% vs. 12% in males, P=0.01) while the age of AHG PRA (+) group was higher than the (-) group (37+/-16 vs. 28+/-13, P<0.05). Overall 5-yr graft survival rate was 92%. Donor age was higher (42+/-11 vs. 27+/-16, P<0.0001) and HLA was better matched (Chi-square, P<0.01) in the living compared to the cadaveric group. In univariate analysis, recipient age > 45, donor age > 50 and AHG PRA (+) were associated with worse graft survival. In multivariate analysis, donor age > 50 along with AHG PRA (+), or donor age > 50 with recipient age > 45 were significant prognostic factors for graft survival. Recipient age >45, donor age > 50 and AHG PRA (+) were still prognostic of long-term graft fates in cadaveric transplants. CONCLUSION: AHG PRA correlates better with clinical data than NIH PRA and pre-transplant PRA is a significant prognostic factor for long-term graft fates in cadaveric renal recipients in Koreans.
