Comparison of panel-reactive antibody levels in Caucasian and African American renal transplant candidates.
PRA levels from 58 Caucasian and 70 African American ESRD patients were compared against a panel of cryopreserved lymphocytes from 60 donors (40 Caucasian, 15 African American, 5 others) to determine whether there was significant racial influence on PRA outcome. African Americans were found to have significantly higher mean PRA levels than Caucasians (27% vs. 18%, P = 0.02). Restricting this analysis to only 1 degree transplant candidates showed predictably lower mean PRAs: 6% in Caucasians and 15% in African Americans, but the difference between the two groups remained significant (P = 0.015). The percentage of patients with PRA > or = 10% was also greater among African Americans than Caucasians (43% vs. 24%, P = 0.026). For patients not previously transplanted, the difference between these frequencies remained significant: 11% in Caucasians, 30% in African Americans (P = 0.025). Untransplanted African American patients with positive PRAs (> or = 10%) had significantly higher PRA against African American cell donors (mean = 55%) than against Caucasian cell donors (mean = 44%) (mean difference = 10.6%, P = 0.0056). African Americans were more frequently transfused than Caucasians. The percentage of patients not previously transplanted receiving 0, 1-5, and > 5 transfusions were 69%, 22%, and 9% for Caucasians and 43%, 44%, and 13% for African Americans (P = 0.03). This higher transfusion rate is the most likely contributor to the elevated PRA levels observed in African Americans.
Cooper
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Histocompatibility Laboratory, Stewart Regional Blood Center, Tyler, Texas 75701, USA.
Jordan
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Willimon
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Land
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GA
D000954:Antigens, Surface / Q000276:immunology; D044383:Black People; D001803:Blood Transfusion; D005260:Female; D006648:Histocompatibility; D006801:Humans; D007518:Isoantibodies / Q000276:immunology*; D007676:Kidney Failure, Chronic / Q000276:immunology / Q000601:surgery; D016030:Kidney Transplantation / Q000276:immunology*; D008214:Lymphocytes / Q000276:immunology; D008297:Male; D012044:Regression Analysis; D012737:Sex Factors; D014019:Tissue Donors; D044465:White People; D001741:Black or African American
D000954:Antigens, Surface; D007518:Isoantibodies