Impacts of Pre-transplant Panel-Reactive Antibody on Post-transplantation Outcomes: A Study of Nationwide Heart Transplant Registry Data

Abstract

Author's summary The prevalence of sensitized patients waiting for heart transplantation (HTx) is increasing. We assessed the prevalence and clinical impact of panel-reactive antibody (PRA) in patients undergoing HTx using real-world, nationwide, multi-center data. Among patients who underwent HTx during 2014–2021, 19.8% (n=161) had calculated PRA (cPRA) ≥50%. A total of 61 patients underwent desensitization treatment before HTx. More patients with cPRA ≥50% had significantly higher positive flow cytometry crossmatch at HTx and preformed donor-specific antibody than those with cPRA <50%. During follow-up, patients with cPRA ≥50% had significantly lower freedom from antibody-mediated rejection, but the overall survival rate was comparable to those with cPRA <50%.