The Effect Of Panel Reactive Antibody Results On Graft Functions Of Patients With Chronic Kidney Failure

Objectives: This study aims to evaluate panel reactive antibody (PRA) results of patients with chronic kidney failure (CKF) and to obtain information about pre-transplantation PRA results and graft function of transplanted patients.Patients and methods: We evaluated PRA results of 2,517 patients (1,428 males, 1,089 females; mean age 49.9 +/- 14.7; range 2 to 82 years) with CKF on the waiting list and 304 transplanted patients (178 males, 126 females; mean age 41.1 +/- 11.4; range 9 to 71 years). Of the PRA tests, 85% and 15% were performed by Luminex and flow cytometric methods, respectively. The final post-transplantation serum creatinine levels and transplantation ages of the patients were recorded. We also assessed glomerular filtration ratio (GFR) for graft functions of transplanted patients.Results: Of the PRA positive patients (40.52%) on the waiting list, 12.55% were class I PRA positive (group 1), 8.78% were class II PRA positive (group 2), and 19.19% were both class I and II PRA positive (group 3). Of the patients, 59.48% were PRA negative (group 4). Pre-transplantation negative PRA results (group 4) were significantly higher among patients who were transplanted from related donor (78.09%) than patients with cadaveric transplantation (48.88%) and patients on the waiting list (59.48%) (p<0.05). Glomerular filtration ratios (GFRs) were higher among patients who were transplanted from related donor for all PRA groups. Of transplanted patients, although GFR values of the patients who had acute rejection episode (ARE) were higher than those without ARE, there was no statistically significant difference in between.Conclusion: Regularized pre-transplantation PRA tests and cautious evaluation of their results constitute great importance to prevent ARE and increase graft survival in Turkey, which is a country with already low organ donation ratios.