Importance of peak PRA in predicting the kidney transplant survival in highly sensitized patients

Transplantation Proceedings
D SinghJ Lawen

Abstract

Do patients with high historic peak panel-reactive antibodies (PRA) remain high risk if their PRA levels fall before transplantation? We examined retrospectively 406 first and repeat kidney recipients with a peak PRA of >50%, who were transplanted from our center between January 1990 and December 2001. Univariate analysis by log-rank test was performed for variables that affect graft survival. The factors tested included current PRA, peak PRA, difference between peak and current PRA (DeltaPRA), HLA mismatch, gender, age, transplant number, and donor source. Receiver operator characteristic curves (ROC) were generated to obtain the best cutpoints for current PRA and DeltaPRA. Current PRA (P < .0001), peak PRA (P = .0004), and DeltaPRA (P = .0015) were significant predictors by univariate analysis. However, in a multivariate model, peak PRA was not significant. Current PRA (P < .0001) was significantly associated with graft survival, while DeltaPRA showed a strong trend to significance (P = .05). Current PRA of <26% and DeltaPRA of >37% were the best cutpoints for separating good and poor outcomes. This study shows that current PRA and DeltaPRA impact on graft survival in highly sensitized (>50%) patients. Sensitized patients wit...Continue Reading

References

Aug 30, 2008·Lancet·Shuzhong GuoHuiyuan Li
Feb 3, 2015·Transplant International : Official Journal of the European Society for Organ Transplantation·Lu HuberKlemens Budde
Feb 15, 2018·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jinwen LinJianghua Chen
Dec 28, 2007·The Korean journal of laboratory medicine·Choong-Hwan ChaSoon Young Jung
Aug 8, 2008·Current Opinion in Organ Transplantation·Andrea A ZacharyMary S Leffell

Related Concepts

Transplanted Kidney
T-Lymphocyte
Pancreatitis, Graft
Graft Survival
Survival Analysis
Isoantibodies
Graft Loss
Receiver Operating Characteristic
Adjustment Disorders
Transplantation Aspects

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