Predictive value of enzyme-linked immunosorbent assay-detected IgG anti-HLA antibodies for pediatric renal allograft rejection

Transplantation
L K Dalla VecchiaMark D Pescovitz

Abstract

Measurement of panel-reactive antibody (PRA) with an enzyme-linked immunosorbent assay using soluble HLA class I molecules (PRA-STAT) in adult renal transplant recipients predicted graft loss and rejection. We sought to confirm this finding in pediatric recipients, an immunologically distinct group. The population consisted of 158 renal transplants in 146 patients (age range, 1-21 years). PRA was determined with PRA-STAT and microlymphocytotoxicity (CDC), using final cross-match sera. An elevated test was defined as > or =5% reactivity. Statistical analysis for rejection used the chi-square test and for graft survival used the log-rank test. Thirty-five patients (22%) had %PRA-STAT > or =5%, compared with 26 (16%) with %PRA-CDC > or =5%. The percentage with elevated %PRA-STAT was found to correlate with subsequent transplantations (first, 15%; second, 67%; third, 75%). Subsequent analyses utilized only the 136 primary recipients, of whom 20 (15%) had %PRA-STAT > or =5% and 16 (12%) had %PRA-CDC > or =5%. Elevated %PRA-STAT correlated with rejection at 3 months (65% vs. 36%), 12 months (84% vs. 50%), and 24 months (84% vs. 54%) (P<0.05). No association was found between elevated %PRA-CDC and rejection. Patients with %PRA-STAT > ...Continue Reading

References

Dec 1, 1992·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·R B Ettenger
Jan 1, 1993·Transplant International : Official Journal of the European Society for Organ Transplantation·A W HarmerK I Welsh
Jul 1, 1996·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·J ReganR Buelow
Aug 1, 1996·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·E C Kohaut, A Tejani

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Citations

Jul 22, 2005·Surgery Today·Junchao Cai, Paul I Terasaki
Jun 7, 2005·Human Immunology·Sylvie Di FilippoAdriana Zeevi
Mar 15, 2000·Transplantation Proceedings·C Suberbielle-BoisselC Raffoux
Jun 10, 2004·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Salvatore di PaoloPaolo F Schena
Oct 2, 2001·Transplantation·UNKNOWN Canadian Neoral Renal Transplantation Study Group
Apr 1, 2006·Pediatric Transplantation·Alin L GirnitaAdriana Zeevi

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