Analysis of AHG-PRA and ELISA-PRA in kidney transplant patients with acute rejection episodes.
Many centers determined a significant correlation between post-transplant anti-HLA antibodies production and clinical outcome. In order to confirm this correlation and ascertain the sequential appearance of anti-HLA antibodies, we compared the ELISA (ELISA-PRA) and the anti-human globulin enhanced complement-dependent lymphocytotoxicity panel-reactive antibodies test (AHG-PRA) with the occurrence of acute rejection episodes. Thirty patients who underwent kidney transplantation between December 1998 and October 1999 were assayed. One pre-transplant and 10 post-transplant serum samples were tested from each recipient except from one of them who lost his graft on the 1 week post-transplant. The diagnosis of acute rejection episode was based on classical criteria (fever, graft swelling and tenderness, oliguria, weight gain) and a rapid rise in serum creatinine levels, confirmed by an allograft biopsy graded by the Banff working classification. The 322 pre- and post-transplant serum specimens were tested by AHG-PRA methodology and 298 of them by the ELISA-PRA. The agreement coefficient (kappa) for both methodologies was 0.63. There were 27 acute rejection episodes in 19 patients. AHG-PRA results were significantly correlated (Hazard ratio=10.06; P=0.006) with this occurrence. These data were not confirmed with the ELISA-PRA procedure. Our results suggest that a routine post-transplant AHG-PRA test offers an early risk assessment of acute rejection episodes and may be a useful method for monitoring the kidney transplant evolution.
Kaufman
Arnauld
A
Nephrology Service, State University of Rio de Janeiro (UERJ), Av. Professor Manoel de Abreu, 444, 3o andar, DHE, 20550-170, Vila Isabel, Rio de Janeiro, Brazil.
de Souza Pontes
Luciane Faria
LF
Queiroz Marques
Maria Teresa
MT
Sampaio
José Cavaliere
JC
de Moraes Sobrino Porto
Luís Cristóvão
LC
de Moraes Souza
Edison Régio
ER
D000293:Adolescent; D000328:Adult; D000906:Antibodies / Q000032:analysis; D002648:Child; D003601:Cytotoxicity Tests, Immunologic / Q000379:methods; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D015395:Histocompatibility Antigens Class I / Q000276:immunology*; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D000906:Antibodies; D015395:Histocompatibility Antigens Class I