Sensitization to kidney transplants.
1. Greater than 50% PRA-sensitized first kidney graft recipients show significantly lower graft survival rates than nonsensitized (0-10% PRA) and moderately sensitized (11-50% PRA) recipients. Most of the effect of sensitization can be seen within the first month posttransplantation. 2. Increases in cellular immunity or antibodies not currently detected by lymphocyte cytotoxicity may account for the decreased graft survival rates in second and multiple graft recipients. One possibility involves the presence of antiplatelet antibodies. 3. Transfusions seem to be the weakest stimulus for sensitization when compared to pregnancy, and to graft failure, which is the strongest. In addition, low numbers of transfusions tend to have a beneficial effect, especially on second kidney graft survival. 4. During the years since the prospective use of the T-cell FCXM by Los Angeles transplant centers, there has been a marked increase in graft survival rates for multiple graft recipients. However, the rates for the sensitized multiple transplant group still remain lower than those for the nonsensitized first and multiple graft groups.
Rankin
G W
GW
Wang
X M
XM
Terasaki
P I
PI
D002102:Cadaver; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D007114:Immunization; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D011247:Pregnancy; D044469:Racial Groups; D012042:Registries; D012189:Retrospective Studies; D014481:United States