The Impact of Duration on Dialysis on the Pre-Transplant Allosensitization According to Panel Reactive Antibody Levels
1Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
2Department of Surgery, College of Medicine, Ewha Women's University, Seoul, Republic of Korea
3Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
4Departments of Nephrology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Meeting: 2018 American Transplant Congress
Abstract number: C138
Keywords: Alloantibodies, Antibodies, Histocompatibility antigens, Risk factors
Session Information
Date: Monday, June 4, 2018
Session Name: Poster Session C: Kidney Living Donor Issues
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Purpose : Presensitization to human leukocyte antigen(HLA) is one of the most important barriers to overcome in the field of renal transplantation. Due to the development of the techniques in dialysis as well as the organ shortage, the number of patients in the waiting list and their duration on dialysis have been increasing and the risk for sensitization rises as well. Hence, the purpose of our study was to investigate the relationship between the duration on dialysis and panel reactive antibody(PRA) score as the indicator for allosensitization.
Methods : A total of 1196 patients who underwent renal allograft between 2008 to 2015 were included. The patient information on the dialysis history, the duration on dialysis (pre-emptive, <5 or ≥5 years), history for transfusion, pregnancy, and prior transplantation were collected retrospectively, to find their effects on pre-transplant PRA score. The PRA score is expressed as a percentage between 0% and 100%, which represents the presence of class-I or II anti-HLA antibodies (class-I or II PRA positivity). Univariate and multivariate analyses were performed to find significant factors related to PRA score.
Results : In the univariate analysis, class-I PRA positivity was significantly related to the increased duration on dialysis, as well as the previous histories for pregnancy and transplantation. For class-II PRA positivity, univariate analysis showed positive correlations of PRA score to increased duration on dialysis, the previous history for transfusion, pregnancy, and prior transplantation. In multivariate analysis, increased dialysis duration was strongly related to class-I PRA positivity (HR 3.6, 95% CI 1.8-5.4, p<0.001) and class-II PRA positivity (HR 2.8, 95% CI 1.0-4.5, p=0.002) as well as previous history of transplantation. Dialysis duration was significantly related to PRA score in both class-I and class-II PRA positivity.
Conclusions : In end-stage renal disease patients, as the duration on dialysis increases, the risk for allosensitization to HLA rises, as shown in PRA score.
CITATION INFORMATION: Jung Y., Kim D., Lee J., Song S., Lee J., Kim B., Lee J., Kim S., Kim M., Kim S., Kim Y., Huh K. The Impact of Duration on Dialysis on the Pre-Transplant Allosensitization According to Panel Reactive Antibody Levels Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Jung Y, Kim D, Lee J, Song S, Lee J, Kim B, Lee J, Kim S, Kim M, Kim S, Kim Y, Huh K. The Impact of Duration on Dialysis on the Pre-Transplant Allosensitization According to Panel Reactive Antibody Levels [abstract]. https://atcmeetingabstracts.com/abstract/the-impact-of-duration-on-dialysis-on-the-pre-transplant-allosensitization-according-to-panel-reactive-antibody-levels/. Accessed March 8, 2021.« Back to 2018 American Transplant Congress