Relationship between panel reactive antibody level and renal acute rejection

Baoxiang JIA; Junjie WU; Ye TIAN

ABSTRACT

BACKGROUND:

It is confirmed that panel reactive antibody (PRA) and its immune level is closely related to rejection activation, renal survival rate and the realization of the renal function. Study addressing the relation PRA level and acute rejection has great clinical significance for forecasting acute rejection and improving the renal survival rate.

OBJECTIVE:

To analyze the relation of PRA and acute rejection prior to and after transplantation by detecting PRA level combined with patient rejection.DESIGN, TIME AND

SETTING:

Retrospectively case analysis was performed at the Affiliated Beijing Friendship Hospital of Capital University of Medical Sciences from September 1998 to May 2005.

PARTICIPANTS:

A total of 633 patients receiving renal transplantation were collected, including 348 males and 285 females, aged 16-67 years.

METHODS:

Company Lymphocyte Tray produced by One Lambda and Biotest were used for this study, serum PRA level was detected prior to and within 2 months after transplantation.MAIN OUTCOME

MEASURES:

Pre- and post-transplant PRA level and clinical rejection.

RESULTS:

Totally 591 patients were PRA negative in pre-transplant assay, and 164 patients were positive, 10.32% (61/591) patients occurred acute rejection; 42 patients were PRA positive in pre-transplant assay, and 71.42% (30/42) patients occurred acute rejection. The difference between PRA negative or positive and acute rejection had significance (P < 0.001). 427 patients were PRA negative in both pre- and post- transplant assay, 5.6% (24/427) patients occurred acute rejection. 164 patients were PRA negative in pre-transplant assay, but positive in post-transplant, 42.7% (70/164) patients occurred acute rejection. The comparison of PRA negative pre-transplant and PRA positive post-transplant combined with acute rejection had difference (P < 0.001). The correlation coefficient of pre-transplant PRA and acute rejection was 0.612, which was 0.658 between post-transplant PRA and acute rejection, there was obvious association when P=0.01.

CONCLUSION:

PRA plays an important role in forecasting renal rejection. The acute rejection probability is higher in patients with positive PRA; in other hand, the probability is lower in patients with negative PRA.