title: Impact of pretransplant exposure to allosensitization factors generating HLA antibodies in the Luminex era.
abstract: To identify the frequency of exposure to sensitizing factors and evaluate the risk ascribable to each sensitizing factor generating HLAabs measured by Luminex.
  
  
  
  This is a retrospective cohort study that included 502 transplanted patients and 51 patients on the waiting list for a deceased donor graft. Patients were divided into 4 groups according to the %PRA: 0%, 1 to 19%, 20 to 49% and ≥50%. The OR attributable to each sensitizing factor or combination were calculated.
  
  
  
  Of the total 553 subjects, 53.5% were male, with an average age 35.42±12.96years. 69.1% were exposed to one or more sensitizing factors; 44.8% had %PRA class I≥1 and 38.9% had %PRA class II≥1. Independently or combined, sensitizing factors persist as a risk factor for the development of a %PRA >1%, >20% or >50%. After multivariate analysis, the three sensitizing factors remained significantly associated to HLAab development.
  
  
  
  In spite of using a most sensitive technique such as Luminex to measure the %PRA, a clear association persists between exposure to sensitizing factors and a high %PRA. The risk increases after exposure to more than one sensitizing factor.
authors.affiliation: Transplant Nephrology Division, Department of Nephrology and Mineral Metabolism, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Vasco de Quiroga 15, Belisario Domínguez Sección XVI, CP 14080 Mexico City, Mexico.
authors.forename: Araminta
authors.initials: A
authors.lastname: Guichard-Romero
authors.affiliation: Transplant Nephrology Division, Department of Nephrology and Mineral Metabolism, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Vasco de Quiroga 15, Belisario Domínguez Sección XVI, CP 14080 Mexico City, Mexico.
authors.forename: Lluvia Aurora
authors.initials: LA
authors.lastname: Marino-Vazquez
authors.affiliation: Department of Transplantation, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Vasco de Quiroga 15, Belisario Domínguez Sección XVI, CP 14080 Mexico City, Mexico.
authors.forename: Natalia
authors.initials: N
authors.lastname: Castelán
authors.affiliation: Department of Transplantation, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Vasco de Quiroga 15, Belisario Domínguez Sección XVI, CP 14080 Mexico City, Mexico.
authors.forename: Mayra
authors.initials: M
authors.lastname: López
authors.affiliation: Department of Transplantation, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Vasco de Quiroga 15, Belisario Domínguez Sección XVI, CP 14080 Mexico City, Mexico.
authors.forename: Norma
authors.initials: N
authors.lastname: González-Tableros
authors.affiliation: Department of Transplantation, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Vasco de Quiroga 15, Belisario Domínguez Sección XVI, CP 14080 Mexico City, Mexico.
authors.forename: Adriana
authors.initials: A
authors.lastname: Arvizu
authors.affiliation: Department of Transplantation, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Vasco de Quiroga 15, Belisario Domínguez Sección XVI, CP 14080 Mexico City, Mexico.
authors.forename: Adrián
authors.initials: A
authors.lastname: De Santiago
authors.affiliation: Department of Transplantation, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Vasco de Quiroga 15, Belisario Domínguez Sección XVI, CP 14080 Mexico City, Mexico.
authors.forename: Josefina
authors.initials: J
authors.lastname: Alberú
authors.affiliation: Transplant Nephrology Division, Department of Nephrology and Mineral Metabolism, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Vasco de Quiroga 15, Belisario Domínguez Sección XVI, CP 14080 Mexico City, Mexico. Electronic address: luis_buenrostro@yahoo.com.
authors.forename: Luis Eduardo
authors.initials: LE
authors.lastname: Morales-Buenrostro
mesh_terms: D015331:Cohort Studies; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology*; D006650:Histocompatibility Testing / Q000379:methods; D006801:Humans; D056724:Immunity, Humoral; D007114:Immunization; D007518:Isoantibodies / Q000097:blood*; D007519:Isoantigens / Q000276:immunology*; D016030:Kidney Transplantation; D008297:Male; D008800:Mexico / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D006680:HLA Antigens; D007518:Isoantibodies; D007519:Isoantigens
keywords: Allosensitization factor; Kidney transplantation; Panel reactive antibody; Transfusion; Waiting list