Panel Reactive Antibodies in Post-Kidney Transplantation
TASANEE MONGKOLSUK, M.Sc.*, KANCHANA SUJIRACHATO, Ph.D.*, SUREEPORN JUNPONG, B.Sc.*, VASANT SUMETHKUL,M.D.**, SOMNUEK DOMRONGKITCHAIPORN, M.D.**, PIMOL CHIEWSILP, M.D.*
Affiliation : * Histocompatibility & Immunogenetics Laboratory, Sirikit Medical Center, ** Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Bangkok 10400, Thailand.
Abstract This study was aimed to evaluate the clinical relevance of the panel reactive antibodies (PRA) post kidney transplantation (KT). A total number of 90 KT recipients consisted of 71 male and 19 female patients. Thirty-two haploidentical and 3 HLA-identical pairs for living related KT and 55 cadaveric KT with 3-6 mismatched antigens were il}Cluded in this study. The analysis revealed that there were 2 out of 69 (2.89%) patients with no episode of rejection who had Pre-KT PRA-T and or PRA-B > 80 per cent while they were 5.79 per cent and 23.19 per cent for Post-KT. No patient in 21 cases with KT rejection had Pre-KT-PRA-T and -B > 80 per cent. There was sig- nificant increase of antibodies in Post-KT rejections which were 28.57 per cent and 33.3 per cent for Post-KT-PRA-T and -B respectively. None of 3 cases with graft failure (GF) from chronic rejection had Pre-KT-PRA-T and -B >20 per cent and only one of them had Post-KT-PRA-T = 80 per cent. No donor specific HLA antibody was found among this group of patients. Although antibody to donor HLA antigens was not observed in these patients, the increase of PRA-T and -B in Post-KT may indicate the immunological reaction resulting in GF.
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