[Panel reactive antibody screening and human leukocyte antigen typing in 1 700 cases of renal transplantation].
OBJECTIVE
To evaluate the role of panel reactive antibody (PRA) screening and human leukocyte antigen (HLA) typing in renal transplantation.


METHODS
PRA screening and HLA typing were performed in 1 700 patients eligible for the first group of renal transplantation who had 3 to 6 HLA matches in HLA-A, B and DR with the donor, and in cases positive for PRA, plasma exchange was conducted. Another 423 patients who did not receive PRA screening or HLA typing constituted the second group. The changes of immune variables, incidences of acute rejection and the effect of HLA-A, B, DR matching on long-term graft survival were observed.


RESULTS
In 1 700 cases of group 1, post-transplantation CsA dose was reduced to 5 to 7 mg*kg(-1)*d(-1) and the graft function recovery time ranged from 2 to 16 d, averaging 5 d. Acute graft rejection occurred in 252 (14.8%) cases, but no hyper-acute rejection was observed. The 1-, 3- and 5-year patient/graft survival rates were 98.6%/96.7%, 93.1%/87.3% and 88.1%/83.6% respectively. In group 2, CsA dose ranged from 8 to 12 mg*kg(-1)*d(-1) and the graft function recovery time was 4 to 30 d, averaging 13 d. Hyper-acute rejection occurred in 9 (2.1%) and acute rejection in 198 (46.8%) cases, and the 1-, 3- and 5-year patient/graft survival rates were 86.7%/76.3%, 72.5%/67.9% and 69.5%/59.3% respectively.


CONCLUSIONS
Negative PRA and good HLA matching can eliminate the incidences of hyper-acute rejection, decrease the rate of acute rejection and improve both patient and graft survival rates.
Yu
Li-Xin
LX
Department of Kidney Transplantation, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.
Yao
Bing
B
Ye
Gui-Rong
GR
Du
Chuan-Fu
CF
Deng
Wen-Feng
WF
Xu
Jian
J
Ma
Jun-Jie
JJ
Fu
Shoa-Jie
SJ
Xiao
Lu-Lu
LL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000276:immunology; D002648:Child; D005260:Female; D006084:Graft Rejection / Q000276:immunology* / Q000401:mortality; D006680:HLA Antigens / Q000145:classification* / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged
D000906:Antibodies; D006680:HLA Antigens