The role of PRA measurement and HLA-antigen matching in renal transplantation

Objective To evaluate the role of PRA measurement and HLA antigen matching in renal transplantation. Methods PRA measurement and HLA antigen matching have been carried out for 1 020 patients on the waiting list for renal transplantation.These patients have underwent plasma exchange and HLA A,B,DR were well matched no matter PRA being negative or positive.423 patients with neither PRA measurement nor HLA antigen matching served as controls.The patient and graft outcome have been observed. Results In the 1 020 cases studied,the post transplantation CsA dose was 5～7mg·kg -1 ·d -1 and the graft function recovery time 2～16 days with a mean of 5 days.Acute graft rejection occurred in 173 (17.0%) with no hyper acute rejection observed.The 1,3,and 5 year patient/graft survival rates were 98.3%/96.0%,93.0%/85.2% and 88.0%/82.6% respectively.In the controls,CsA dose ranged from 8 to 12mg·kg -1 ·d -1 and the graft function recovery time 4～30 days with a mean of 13 days.Hyperacute rejection occurred in 9 (2.1%) and acute rejection in 198 (47%).The 1,3, and 5 year survival rates (patient/graft) were 86.7%/76.3%,72.5%/67.9% and 69.5%/49.3% respectively. Conclusions Negative PRA and well matched HLA antigen would eliminate the occurrence of hyperacute rejection,lessen the occurrence of acute graft rejection and makes the patient/graft outcome better.