Frequency of Panel Reactive Antibodies (PRA) among Renal Transplant Recipients and its Effect Modifiers

J Coll Physicians Surg Pak. 2020 Sep;30(9):966-969. doi: 10.29271/jcpsp.2020.09.966.

Abstract

Objective: To determine frequency of panel reactive antibodies among renal transplant recipients and its effect modifiers.

Study design: A cross-sectional study.

Place and duration of study: Department of Immunology, Armed Forces Institute of Pathology from October 2016 to October 2017.

Methodology: One hundred and sixty-two (162) patients, who were referred to Department of Immunology for pre-transplant workup for kidney transplantation of both genders and Pakistani nationality. Informed consents were taken and detailed history were recorded. Frequency and percentages were calculated for panel reactive antibodies, blood transfusion, pregnancy and previous transplant were noted and Chi-square test was applied.

Results: One hundred and sixty-two (162) patients including 141 males and 21 females were analysed and 48 patients (30%) were positive for panel reactive antibodies (PRA). Of 141 male patients analyzed, 35 were positive for PRA, which were about 25%. Twenty-one females were tested for PRA and 13 female patients were positive that is about 62% of the analysed population. Out of the total 141 males, 20 (14%) had blood transfusion and of these 11 (55%) were positive for PRA. Without history of transfusion, only 9 (7%) were positive for PRA. Out of 21 females, 10 were positive for blood transfusion, out of which 6 (60%) were positive for PRA. Without history of blood transfusion, 7 (64%) were positive for PRA. Out of 21 females, 20 had history of pregnancy. Out of whom, 13 (65%) were positive for PRA. Two patients (one male and one female) were with history of previous transplant and both were positive for PRA.

Conclusion: A significant number of patients were sensitised with panel reactive antibodies waiting for renal transplant. The PRA was more common in recipients who were prone to effect modifiers such as pregnancy, blood transfusion and re-transplant. These risk factors were mostly present in combination, which also suggests their synergistic effects on PRA synthesis. Key Words: Blood transfusion, Effect modifiers, Panel reactive antibodies, Pregnancy, Kidney transplant, Re-transplant.

MeSH terms

  • Blood Transfusion
  • Cross-Sectional Studies
  • Female
  • Graft Rejection
  • HLA Antigens
  • Humans
  • Isoantibodies
  • Kidney Transplantation*
  • Male
  • Pregnancy
  • Risk Factors

Substances

  • HLA Antigens
  • Isoantibodies