title: [Calculated panel reactive antibody method for assessing the probability of kidney recipients to receive transplantation].
abstract: OBJECTIVE
  To establish a calculated panel reactive antibody (CPRA) method to analyze the donor-recipient incompatibility rate in PRA-positive kidney recipients and estimate the probability of these recipients to receive kidney transplantation.
  
  
  METHODS
  Based on the database of HLA-A, -B, -DR genes and A-B, A-DR, B-DR, A-B-DR haplotype frequencies collected from 2004 donors from Jan 2000 to Dec 2012, we analyzed CPRA in 202 PRA-positive recipients and evaluated the consistency between PRA and CPRA assessments using a CPRA-Java calculator software, which returned a percentage of CPRA (representing the probability of unacceptable HLA in the donor group) after input of HLA-specific antibodies of a PRA-positive recipient.
  
  
  RESULTS
  The mean PRA intensity of the 202 PRA-positive recipients was (23.12∓17.83)% with a mean CPRA% of (46.07∓23.30)%. A significant difference was found between the mean PRA% and CPRA% in low sensitized recipients (PRA 0-10%) [(6.87∓2.41)% vs (21.63∓11.75)%, P<0.05) and in moderately sensitized recipients (PRA 10%-30%) [(20.15∓5.70)% vs (50.56∓16.86)%, P<0.05), but not in highly sensitized recipients (PRA>30%); The concordance rates between PRA% and CPRA% in the 3 groups were 19.35% (P<0.05), 10.99% (P<0.05), and 100% (P>0.05), respectively.
  
  
  CONCLUSIONS
  Lowly sensitized kidney recipients might have a lower probability of actually receiving a transplant than PRA% shows. A PRA%>30% is a risk factor for kidney transplantation. PRA reflects the sensitized level of a renal recipient, and reliable detection of HLA antibody specificity is of critical importance. CPRA accurately reflects the probability of a recipient to receive a transplant to assist clinicians in predicting the waiting time and selecting the transplant approach.
authors.affiliation: Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.E-mail: bearbear_cn@163.com.
authors.forename: Min
authors.initials: M
authors.lastname: Luo
authors.forename: Lixin
authors.initials: L
authors.lastname: Yu
authors.forename: Lulu
authors.initials: L
authors.lastname: Xiao
mesh_terms: D000906:Antibodies; D000918:Antibody Specificity; D006084:Graft Rejection / Q000276:immunology; D006085:Graft Survival / Q000276:immunology*; D006680:HLA Antigens / Q000235:genetics; D006238:Haploidy; D006650:Histocompatibility Testing / Q000379:methods; D006801:Humans; D016030:Kidney Transplantation
chemical_list: D000906:Antibodies; D006680:HLA Antigens