Effect of recipient sensitization (peak PRA) on graft outcome in haploidentical living related kidney transplants

Barama, Azemi; Oza, Umesh; Panek, Romuald; Belitsky, Philip; Macdonald, A. S.; Lawen, Joseph; McAlister, Vivian C.; Kiberd, Bryce A.

doi:10.1034/j.1399-0012.2000.140306.x

Cited by 39 publications

(19 citation statements)

References 10 publications

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“…They also found significantly higher PRA (a PRAϾ50% was present in 10.7% of HCV Ab positive patients versus 1.3% of HCV-negative patients, P ϭ 0.001) and higher retransplantation rates (10.6% versus 4.3%, P ϭ 0.034) in hepatitis C positive patients, but these variables were excluded from their multivariable analysis because they barely missed reaching statistical significance as predictors of graft loss in univariate analysis with reported p-values ranging from 0.056 to 0.12). Of note, however, several studies have reported PRA to be an important predictor of renal graft loss (22)(23)(24). We also found higher PRA and retransplantation to be predictive of renal allograft loss in univariate analysis.…”

Section: Discussionsupporting

confidence: 69%

Hepatitis C, Acute Humoral Rejection, and Renal Allograft Survival

Forman

Tolkoff-Rubin²,

Pascual³

et al. 2004

Journal of the American Society of Nephrology

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Abstract. The effect of recipient hepatitis C virus (HCV) infection on renal allograft loss and acute rejection in kidney transplantation remains controversial. We studied 354 renal allograft recipients transplanted during 1996 to 2001 who had HCV antibodies (Ab) measured before transplantation. The primary outcome was death-censored allograft loss and the secondary outcome was acute humoral rejection (AHR). Compared with HCV Ab-negative patients, those with positive HCV Ab had longer time on dialysis before transplantation, higher percentage of panel-reactive antibodies (PRA), were more likely to receive a cadaveric transplant, and were more likely to develop delayed graft function (DGF). In univariate analyses, predictors of renal allograft loss included HCV, cadaveric graft, PRA Ͼ20%, HLA mismatch Ն5, retransplantation, DGF, induction therapy, and AHR. When adjusted for PRA Ͼ20%, HLA mismatch Ն5, and multiple transplant status, HCV was not a statistically significant predictor of allograft loss. HCV was also associated with AHR but lost significance when adjusted for PRA Ͼ20%. HCV Ab-positive patients were more likely to have longer duration of dialysis before transplantation prior to kidney transplants, higher PRA, and to receive cadaveric transplants. These characteristics likely resulted in more DGF and AHR after transplantation. After adjusting for these confounding factors, the association between HCV Ab positivity and renal allograft loss was notably attenuated and no longer statistically significant.

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Section: Discussionsupporting

confidence: 69%

Hepatitis C, Acute Humoral Rejection, and Renal Allograft Survival

Forman

Tolkoff-Rubin²,

Pascual³

et al. 2004

Journal of the American Society of Nephrology

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“…1,3,4 Solid-phase single antigen bead assay techniques have facilitated more complete characterization of donor and recipient HLA antigens and allelic variants. 7,9 Therefore, virtual crossmatching has enabled prediction of actual crossmatch results with a high degree of sensitivity and specificity.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] The Scientific Registry of Transplant Recipients data have shown that time on wait lists is 2 to 3 times longer for patients with elevated PRA levels. 5 In addition, Opelz and associates reported that 1-year and 5-year graft survival for patients with high PRA levels were lower than for patients with low PRA levels.…”

Section: Introductionmentioning

confidence: 99%

Untitled

Rohan

Taber

Moussa

et al. 2017

Exp Clin Transplant

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“…The percentage of lymphocytes giving a positive reaction (cell death) over the total number tested is the PRA of the patient. Sensitized patients who have been exposed to Class I and Class II HLA (human leukocyte antigens) via transfusions, pregnancies and previous transplants are likely to have PRA because they harbor many anti-HLA antibodies that react with larger pool of the donor leukocyte panel [42]. In this assay, it was difficult to determine the exact target of the anti-HLA antibodies since each lymphocytes of the donor would express more than one Class I and II HLA molecules.…”

Section: Patient Assessment: Histocompatibility Testingmentioning

confidence: 99%