Effect of human recombinant erythropoietin therapy on panel reactive antibodies in chronic dialysis patients.
To examine whether recombinant human erythropoietin (rhEPO) therapy results in decreased presensitization to foreign HLA antigens, we retrospectively analyzed data from 64 of 200 patients treated in a university hospital dialysis center between 1985 and 1995 who had undergone routine panel reactive antibody (PRA%) screening. Though a significant decrease in the annual frequency of highly sensitized patients over the years was noted, 16 patients followed for 27.1 +/- 3.7 months after initiation of rhEPO therapy until transplantation or blood transfusion showed no significant overall decrease in PRA%. Six highly presensitized patients had moderate but significant overall decrease in PRA%. However, in three of these patients the PRA% was unchanged and in the other three patients the PRA% remained over 50%. Thus rhEPO therapy reduced the incidence of highly presensitized patients, but previously presensitized patients remained presensitized. We conclude that removal of transfusional stimulation of lymphocytotoxic antibody production does not appear to benefit previously presensitized patients, possibly due to the maintenance of B-lymphocyte clonal expansion by unknown factors, or even by rhEPO itself.
Friedlaender
M M
MM
Nephrology Service, Hadassah University Hospital, Jerusalem, Israel.
Azem
O
O
Rubinger
D
D
Brautbar
C
C
D000961:Antilymphocyte Serum / Q000097:blood*; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006680:HLA Antigens / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000276:immunology* / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008403:Mass Screening; D010530:Peritoneal Dialysis; D011994:Recombinant Proteins / Q000627:therapeutic use; D006435:Renal Dialysis; D012189:Retrospective Studies; D065227:Transfusion Reaction
D000961:Antilymphocyte Serum; D006680:HLA Antigens; D011994:Recombinant Proteins; D004921:Erythropoietin