PANEL‐REACTIVE ANTIBODY POSITIVITY AND ASSOCIATED HLA‐ANTIBODIES IN TURKISH END‐STAGE RENAL DISEASE PATIENTS

Abstract

Pre and postrenal transplantation panel reactive antibody (PRA) screening is associated with increased rates of hyperacute or acute‐graft rejection and graft loss. It has been suggested that phenotypic HLA‐antigens are involved in PRA sensitization. This study investigated the relationships between HLA‐specific antibody frequencies and PRA sensitization in Turkish patients with end‐stage renal disease (ESRD). Three hundred and forty patients on the renal transplantation waiting list participated. We determined the level of PRA sensitization and the candidates' class I and II HLA‐antibody profile. Panel reactive antibody levels greater than 30% were accepted as positive. The frequencies of the different antibodies in the sensitized group were calculated. Twenty‐four (7%) of the 340 patients showed PRA‐ABC positivity and 34 (10%) showed DR positivity. Thirty‐nine (11.5%) of the candidates were PRA‐positive. The most frequent class I HLA‐antibodies in this group were A2, A34, and B56, and the most frequent class II antibodies were DR1, DR7, DR10, DR11, DR14, DR52, DQ1, DQ4, DQ6, and DQ7. Analysis showed that the presence of each of these HLA class II antibodies was significantly correlated with PRA positivity. Apart from the presence of HLA‐A2, A24, and DR11 antibodies, the HLA profile for the PRA‐positive candidates differed from that of the general Turkish population. In conclusion, identification of the associated HLA‐specific antibodies and correlation with the Turkish population HLA‐antigen distribution will identify high‐risk patients as candidates for transplantation.