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- Title
Pretransplant virtual PRA and long-term outcomes of kidney transplant recipients.
- Authors
Huber, Lu; Lachmann, Nils; Niemann, Matthias; Naik, Marcel; Liefeldt, Lutz; Glander, Petra; Schmidt, Danilo; Halleck, Fabian; Waiser, Johannes; Brakemeier, Susanne; Neumayer, Hans H.; Schönemann, Constanze; Budde, Klemens
- Abstract
Virtual panel-reactive antibodies (vPRA) have been implemented to gauge sensitization worldwide. It is unclear how it associates with long-term outcomes, and its correlation with peak (pPRA) or actual (aPRA) has not been studied. We retrospectively reviewed data from 18- to 65-year-old kidney-only transplant patients during 1.1.1996-31.7.2011 in our center. PRAs were calculated based on solid-phase techniques. Of the 726 qualified cases, regardless of the PRA type, sensitized patients ( PRA > 5%) had more females and previous transplant. Highly sensitized ( HS, PRA > 50%) had longer waiting time, lower transplant rate, less living donor, more delayed graft function, and acute rejection. The conformity between vPRA and pPRA in HS was 75%, 57% between pPRA and aPRA. Forty-three percent (61/142) patients whose pPRA was >5% had no detectable aPRA and maintained similar outcomes as sensitized patients. Multivariate analysis showed consistently lower death-censored graft survival in HS defined by vPRA [ HR 2.086 (95% CI 1.078-4.037), P < 0.05] and pPRA [ HR 2.139 (95% CI 1.024-4.487), P < 0.05]. Both vPRA and pPRA provided reliable way estimating sensitization and predicting long-term graft survival, while aPRA might underestimate true sensitization. vPRA might be the most objective parameter to gauge sensitization.
- Subjects
KIDNEY transplantation; SENSITIZATION (Neuropsychology); IMMUNOGLOBULINS; TRANSPLANTATION of organs, tissues, etc.; HLA histocompatibility antigens
- Publication
Transplant International, 2015, Vol 28, Issue 6, p710
- ISSN
0934-0874
- Publication type
Article
- DOI
10.1111/tri.12533