title: Analysis of AHG-PRA and ELISA-PRA in kidney transplant patients with acute rejection episodes.
abstract: 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.
authors.affiliation: 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.
authors.forename: Arnauld
authors.initials: A
authors.lastname: Kaufman
authors.forename: Luciane Faria
authors.initials: LF
authors.lastname: de Souza Pontes
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Queiroz Marques
authors.forename: José Cavaliere
authors.initials: JC
authors.lastname: Sampaio
authors.forename: Luís Cristóvão
authors.initials: LC
authors.lastname: de Moraes Sobrino Porto
authors.forename: Edison Régio
authors.initials: ER
authors.lastname: de Moraes Souza
mesh_terms: 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
chemical_list: D000906:Antibodies; D015395:Histocompatibility Antigens Class I