Effectiveness of kidney transplantation in sensitized recipients

Objective To investigate the effectivess of kidney transplantation in sensitized recipients receiving human leukocyte antigen (HLA) and crossreactive groups (CREGs) matching. Methods Recipients' panel reactive antibody (PRA) was detected by using micro complement dependent lymphocytotoxicity test with Lambda cell tray. Donors' and recipients' HLA class Ⅰ typing was performed with special monoclonal tray and HLA class Ⅱ gene typing with micro sequence specific primers (Micro SSP). Results In the 63 recipients PRA positive rate was 12?% ～ 96?% (Mean 51.7?% ); Kidney function recovered in 44 cases in one week. Among the 10 cases of acute rejection (AR),7 were reversed by OKT3 treatment and 3 were failure.Nine cases were subjected to delayed graft function (DGF) and 8 returned normal function in 2 weeks to 2 monthes.The successful rate was 93.7?% (59/63) and mortality rate was 3.2?% (2/63). The incidence of AR and DGF was 15.9?% and 14.3?% respectively. According to the rule of CREGs matching,patients with 0,1 or 2 mismatching (MM) of HLA CREGs were 11 ( 17.5?%) ,29 ( 61.9?% ) and 13 ( 20.6?% ) cases respectively.Conclusion The rule of HLA matching and HLA CREGs must be performed strictly in sensitized recipients and it is very important to reduce allograft acute rejection and enhance the survival rate of allograft.