Detection of Panel Reactive Antibody in Kidney Recipients in Perioperative Period: the Clinical Relevance

Objective: To study the relationship between the level of panel reactive antibody (PRA) in kidney recipients in perioperative period and the acute rejection of the graft. Methods : Thirty-four cases of kidney recipients were enrolled.The level of PRA preoperation, 1,2 and 4 weeks after operation was detected by ELISA-PRA method. Results: Before transplantation, PRA was positive in 9 cases(26.5%), negative in 25 cases(73.5%). The level of PRA in 5/9 cases was more than 50%. The therapy of plasmapheresis was accomplished in those 5 cases before operation. In the group of positive PRA,there was acute rejection in 5 patients, and grafts were removed in 2 patients. In the group of negative PRA, there was acute rejection in 4 patients. After conventional treatment, renal function was reversible into normal. There was significant difference in acute rejection between the groups of positive and negative (P0.05). After transplantation, 11 cases had positive PRA, two of whom were negative of PRA before transplantation. Conclusion: (1)The level of PRA was very important evidence predicting acute rejection before operation; (2)The elevation of PRA after transplantation was correlated with acute rejection and its outcome.