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BACKGROUND: As a result of exposure to human leukocyte antigen(HLA) by pregnancy, blood transfusion and previous organ transplantation, many patients awaiting renal transplantation can develop HLA antibodies. The level of HLA sensitization is determined by PRA(panel reactive antibody) test using a lymphocyte panel from HLA phenotyped selected donors. In Korea, PRA tests have not been performed routinely for organ transplantations. and there is no available data about HLA sensitization in renal transplantation. METHODS: PRA test was done in 136 sera of chronic renal failure(CRF) patients receiving dialysis (hemodialysis 108, peritoneal dialysis 28) by NIH standard microlymphocytotoxicity method with a frozen lymphocytes panel from 36 HLA-typed donors. PRA positive sera were re-tested after dithiothreitol(DTT) treatment and analyzed for HLA antibody specificities. RESULTS: Thirty five out of 136 sera(25.7%) showed positive PRA values in HLA antibody screening test. The PRA(%) values of the 35 positive sera were distributed into 1-10%(n=8), 10-20%(n=7), 20-50%(n=12) and 50%-100%(n=8). respectively. After DTT treatment, the change of PRA reactivity was divided into three groups. The PRA values of Group A(22 sera: 63%) showed no change, Group B(7 sera: 20%) declined, and Group C(6 sera. 17%) completely disappeared after DTT treatment. The specificities of HLA antibodies were identified in 19 out of 35 sera(54%). The success rate in defining antibody specificities was 0 at PRA values of 1-10% and 70-100%, and high at PRA values of 20-70%. CONCLUSION: We observed that about a quarter of CRF patients have developed HLA antibodies of immunoglobulin class-IgG, mixed IgG and IgM, and IgM HLA antibody in decreasing order of frequency.
Antibodies ; Antibody Specificity ; Blood Transfusion ; Dialysis ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Isoantibodies* ; Kidney Failure, Chronic* ; Kidney Transplantation ; Korea ; Leukocytes ; Lymphocytes ; Mass Screening ; Organ Transplantation ; Peritoneal Dialysis ; Pregnancy ; Tissue Donors ; Transplants

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