[Effect of recombinant human erythropoietin on kinetics of alloantibodies in patients awaiting renal allograft].
Iterative transfusions are one of the most important mechanism of the induction as well as maintenance anti-HLA antibodies. We evaluated the evolution of PRA (panel reactive antibodies) in 46 sensitized patients during and after withdrawal of blood transfusion. Twenty nine of them (22 women and 7 men in age 38 +/- 7 years) were treated with EPO for 13 to 60 months. With EPO therapy anemia improved, allowing transfusions withdrawal in 19 patients. PRA level decreased from 62 +/- 23% to 42.5 +/- 25% after 1 year of therapy. At 2 year PRA reduced to 37.7 +/- 30% and remained on this level at 3 year. PRA levels became negative in 4 patients, decreased in 11 (by 35%) and remained high in 7 patients. The results of the patients were compared with 17 sensitized patients (9 women, 8 men in age of 40 +/- 10) who did not receive EPO and only part of them required sporadicly transfusions (mean 3 unit of blood) during last 2-3 years. PRA levels decreased from 59 +/- 20% to 45 +/- 22% at 3 year. PRA became negative in 6 patients. The reduction in PRA levels in this group of patients was lower than in EPO treated patients (24.3% vs 14%) as well as in fewer number of patients PRA droped (53% vs 63%). Analysis of risk factors for persistent high levels of alloantibodies showed, that female sex and DR2 phenotype were significant factors.
Boratyńska
M
M
Z Katedry i Kliniki Nefrologii, Akademii Medycznej we Wrocławiu.
Szewczyk
Z
Z
Nowakowska
B
B
Baldy-Chudzik
K
K
Pytel
A
A
D000328:Adult; D000740:Anemia / Q000276:immunology / Q000628:therapy; D004921:Erythropoietin / Q000494:pharmacology*; D005260:Female; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D007518:Isoantibodies / Q000187:drug effects*; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011292:Premedication; D011994:Recombinant Proteins; D012307:Risk Factors; D012737:Sex Factors
D006684:HLA-DR Antigens; D007518:Isoantibodies; D011994:Recombinant Proteins; D004921:Erythropoietin