Application of Prastat ELISA in the determination of anti-HLA specificity for immunized patients awaiting kidney transplant: five years' experience

Three hundred sixty-five patients who underwent cadaver donor kidney transplantation between 1993 and 1998 were divided into four groups: 40 immunized patients with at least one peak panel-reactive antibody (PRA) value more than 50%, 11 hyperimmunized patients with more than three peak PRA values ov...

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Bibliographic Details
Published in:Transplant international 2000, Vol.13 Suppl 1, p.S99-S105
Main Authors: Buscaroli, A, De Sanctis, L B, Iannelli, S, Stipo, L, Bertuzzi, V, Raimondi, C, Mosconi, G, Liviano D' Arcangelo, G, Scolari, M P, Stefoni, S
Format: Article
Language:English
Subjects:
Actuarial Analysis
Adult
Enzyme-Linked Immunosorbent Assay - methods
Erythropoietin - therapeutic use
Female
Graft Rejection - epidemiology
Graft Rejection - immunology
Graft Survival - immunology
Histocompatibility Testing
HLA Antigens - immunology
Humans
Immunosuppression - methods
Isoantibodies - blood
Kidney Transplantation - immunology
Kidney Transplantation - physiology
Male
Recombinant Proteins
Reoperation
Time Factors
Tissue Donors
Waiting Lists
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Summary:Three hundred sixty-five patients who underwent cadaver donor kidney transplantation between 1993 and 1998 were divided into four groups: 40 immunized patients with at least one peak panel-reactive antibody (PRA) value more than 50%, 11 hyperimmunized patients with more than three peak PRA values over 50%, 10 retransplanted patients and 304 control patients. Before transplantation, we ascertained the antibody specificities against individual HLA antigens (Prastat Sangstat ELISA method for HLA typing of first donor, husbands of multiparous women and potential donors against whom candidates gave positive cross-matches); thus, patients underwent transplantation excluding the presence of the HLA antigens previously detected and looking for high HLA (class I and II) compatibility. Actuarial graft survival after 12 months was satisfactory in all groups: 87% immunized, 81% hyperimmunized and 80% retransplanted vs 92% controls. Renal function at the end of the first year was similar and the number of rejection episodes in the first 3 months did not significantly differ.
ISSN:0934-0874
1432-2277
DOI:10.1007/s001470050289