Panel reactive antibodies is a debatable indicator of post-transplant function and survival
M.L. Mc Cahery, M.C. Clahsen-van Groningen, K.A.L. Mauff, J. Kal-van Gestel, A.T. Rowshani
Chair(s): dr. D.A. Hesselink
Thursday 9 march 2017
12:30 - 12:45h
Categories: Poster - Klinisch
Parallel session: Postersessie - Klinisch 1
Panel reactive antibodies (PRA) estimation is widely used in determining sensitization status and severity. Currently there is no strong evidence supporting that PRA% is predictive as a prognostic measurement for renal allograft outcome. Here, we investigated the value of PRA% as a prognostic indicator of post-transplant function and long-term renal allograft survival.
All patients who received a renal allograft at our Center from 2010 through 2014 were included. We retrospectively analyzed the association of current-pretransplant PRA% (cPRA%) and highest measured PRA% (hPRA%) (cut-off value 6%) with the incidence of rejection and it’s association with kidney function. Patients were divided into three groups. Group 1, control group, is negative for cPRA% and hPRA%. Group 2 is hPRA% positive and cPRA% negative. Group 3 is cPRA% positive and hPRA% positive. Clinical data were collected.
A total of 942 patients was included and 866 for cause renal biopsies were obtained from 471 patients. Strikingly, there is no significant relation between hPRA% and increased biopsy proven rejection rate (P=0.08) No significant difference in eGFR at 3 and 12 months post-transplant was found between groups. The hPRA% positive groups had a trend in developing more proteinuria at 3 and 12 months post-transplant compared to the control group (P=0.05). Also no significant difference was found between the hPRA% positive group and the cPRA% and hPRA% positive group (P=1.00).
We conclude that cPRA% and hPRA% values do not predict the occurrence of rejection and are not associated with graft function and proteinuria up to one year after transplantation. We therefor question the use of PRA% in this setting in prioriting patients for eligibility for solid organ transplantation.
