Predictive value of enzyme-linked immunosorbent assay-detected IgG anti-HLA antibodies for pediatric renal allograft rejection
Measurement of panel-reactive antibody (PRA) with an enzyme-linked immunosorbent assay using soluble HLA class I molecules (PRA-STAT) in adult renal transplant recipients predicted graft loss and rejection. We sought to confirm this finding in pediatric recipients, an immunologically distinct group....
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| Veröffentlicht in: | Transplantation 1997-12, Vol.64 (12), p.1744-1747 |
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| container_title | Transplantation |
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| creator | DALLA VECCHIA, L. K BOOK, B. K MILGROM, M. L JINDAL, R. M LEAPMAN, S. B FILO, R. S PESCOVITZ, M. D |
| description | Measurement of panel-reactive antibody (PRA) with an enzyme-linked immunosorbent assay using soluble HLA class I molecules (PRA-STAT) in adult renal transplant recipients predicted graft loss and rejection. We sought to confirm this finding in pediatric recipients, an immunologically distinct group.
The population consisted of 158 renal transplants in 146 patients (age range, 1-21 years). PRA was determined with PRA-STAT and microlymphocytotoxicity (CDC), using final cross-match sera. An elevated test was defined as > or =5% reactivity. Statistical analysis for rejection used the chi-square test and for graft survival used the log-rank test.
Thirty-five patients (22%) had %PRA-STAT > or =5%, compared with 26 (16%) with %PRA-CDC > or =5%. The percentage with elevated %PRA-STAT was found to correlate with subsequent transplantations (first, 15%; second, 67%; third, 75%). Subsequent analyses utilized only the 136 primary recipients, of whom 20 (15%) had %PRA-STAT > or =5% and 16 (12%) had %PRA-CDC > or =5%. Elevated %PRA-STAT correlated with rejection at 3 months (65% vs. 36%), 12 months (84% vs. 50%), and 24 months (84% vs. 54%) (P or =5% vs. %PRA-STAT or =5% identifies pediatric recipients who are at increased risk for rejection and may benefit from more potent immunosuppression and/or closer monitoring of graft function. |
| doi_str_mv | 10.1097/00007890-199712270-00021 |
| format | Article |
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The population consisted of 158 renal transplants in 146 patients (age range, 1-21 years). PRA was determined with PRA-STAT and microlymphocytotoxicity (CDC), using final cross-match sera. An elevated test was defined as > or =5% reactivity. Statistical analysis for rejection used the chi-square test and for graft survival used the log-rank test.
Thirty-five patients (22%) had %PRA-STAT > or =5%, compared with 26 (16%) with %PRA-CDC > or =5%. The percentage with elevated %PRA-STAT was found to correlate with subsequent transplantations (first, 15%; second, 67%; third, 75%). Subsequent analyses utilized only the 136 primary recipients, of whom 20 (15%) had %PRA-STAT > or =5% and 16 (12%) had %PRA-CDC > or =5%. Elevated %PRA-STAT correlated with rejection at 3 months (65% vs. 36%), 12 months (84% vs. 50%), and 24 months (84% vs. 54%) (P<0.05). No association was found between elevated %PRA-CDC and rejection. Patients with %PRA-STAT > or =5% vs. %PRA-STAT <5% had graft survival at 1 year of 89% vs. 84%, at 2 years of 88% vs. 77%, and at 3 years of 61% vs. 72% (not significant).
Use of %PRA-STAT > or =5% identifies pediatric recipients who are at increased risk for rejection and may benefit from more potent immunosuppression and/or closer monitoring of graft function.</description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/00007890-199712270-00021</identifier><identifier>PMID: 9422414</identifier><identifier>CODEN: TRPLAU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Adolescent ; Adult ; Biological and medical sciences ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Female ; Graft Rejection - diagnosis ; Histocompatibility Antigens Class I ; Humans ; Immunoglobulin G - immunology ; Infant ; Isoantibodies - immunology ; Kidney Transplantation - immunology ; Male ; Medical sciences ; Prognosis ; Retrospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system</subject><ispartof>Transplantation, 1997-12, Vol.64 (12), p.1744-1747</ispartof><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>309,310,314,780,784,789,790,23930,23931,25140,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2127192$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9422414$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DALLA VECCHIA, L. K</creatorcontrib><creatorcontrib>BOOK, B. K</creatorcontrib><creatorcontrib>MILGROM, M. L</creatorcontrib><creatorcontrib>JINDAL, R. M</creatorcontrib><creatorcontrib>LEAPMAN, S. B</creatorcontrib><creatorcontrib>FILO, R. S</creatorcontrib><creatorcontrib>PESCOVITZ, M. D</creatorcontrib><title>Predictive value of enzyme-linked immunosorbent assay-detected IgG anti-HLA antibodies for pediatric renal allograft rejection</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description>Measurement of panel-reactive antibody (PRA) with an enzyme-linked immunosorbent assay using soluble HLA class I molecules (PRA-STAT) in adult renal transplant recipients predicted graft loss and rejection. We sought to confirm this finding in pediatric recipients, an immunologically distinct group.
The population consisted of 158 renal transplants in 146 patients (age range, 1-21 years). PRA was determined with PRA-STAT and microlymphocytotoxicity (CDC), using final cross-match sera. An elevated test was defined as > or =5% reactivity. Statistical analysis for rejection used the chi-square test and for graft survival used the log-rank test.
Thirty-five patients (22%) had %PRA-STAT > or =5%, compared with 26 (16%) with %PRA-CDC > or =5%. The percentage with elevated %PRA-STAT was found to correlate with subsequent transplantations (first, 15%; second, 67%; third, 75%). Subsequent analyses utilized only the 136 primary recipients, of whom 20 (15%) had %PRA-STAT > or =5% and 16 (12%) had %PRA-CDC > or =5%. Elevated %PRA-STAT correlated with rejection at 3 months (65% vs. 36%), 12 months (84% vs. 50%), and 24 months (84% vs. 54%) (P<0.05). No association was found between elevated %PRA-CDC and rejection. Patients with %PRA-STAT > or =5% vs. %PRA-STAT <5% had graft survival at 1 year of 89% vs. 84%, at 2 years of 88% vs. 77%, and at 3 years of 61% vs. 72% (not significant).
Use of %PRA-STAT > or =5% identifies pediatric recipients who are at increased risk for rejection and may benefit from more potent immunosuppression and/or closer monitoring of graft function.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Enzyme-Linked Immunosorbent Assay</subject><subject>Female</subject><subject>Graft Rejection - diagnosis</subject><subject>Histocompatibility Antigens Class I</subject><subject>Humans</subject><subject>Immunoglobulin G - immunology</subject><subject>Infant</subject><subject>Isoantibodies - immunology</subject><subject>Kidney Transplantation - immunology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkDtvFDEUhS0ECkuSn4DkAtEZ_JgZr8soIg9pJShCvbpjX0cOHnuxPZGWIr8dC1a03OY-zndOcQmhgn8S3OjPvJfeGs6EMVpIqTnrFylekY0Y1cAmvuWvyYbzQTChlH5L3tX61JFRaX1Gzswg5SCGDXn5VtAF28Iz0meIK9LsKaZfxwVZDOkHOhqWZU255jJjahRqhSNz2NC2Lt4_3lJILbC73dWfYc4uYKU-F3roydBKsLRggkghxvxYwLe-P3V7yOmCvPEQK16e-jn5fvPl4fqO7b7e3l9f7dhBTlNjYHAEY2Zn_DChNcb6afKKW7ROKpAzbNVoPedOjNKBMgZwQM1nOU8W5lGdk49_cw8l_1yxtv0SqsUYIWFe616bkQ9Sm_-CYpJbKUfdwfcncJ0XdPtDCQuU4_702a5_OOlQLURfINlQ_2FSSC2MVL8By5CL9w</recordid><startdate>19971227</startdate><enddate>19971227</enddate><creator>DALLA VECCHIA, L. K</creator><creator>BOOK, B. K</creator><creator>MILGROM, M. L</creator><creator>JINDAL, R. M</creator><creator>LEAPMAN, S. B</creator><creator>FILO, R. S</creator><creator>PESCOVITZ, M. D</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>19971227</creationdate><title>Predictive value of enzyme-linked immunosorbent assay-detected IgG anti-HLA antibodies for pediatric renal allograft rejection</title><author>DALLA VECCHIA, L. K ; BOOK, B. K ; MILGROM, M. L ; JINDAL, R. M ; LEAPMAN, S. B ; FILO, R. S ; PESCOVITZ, M. D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p266t-a9e5a99bd9f46ec99cf66f30cecd23a2ba835cf00d152da399ae4e70b2b6cab53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Enzyme-Linked Immunosorbent Assay</topic><topic>Female</topic><topic>Graft Rejection - diagnosis</topic><topic>Histocompatibility Antigens Class I</topic><topic>Humans</topic><topic>Immunoglobulin G - immunology</topic><topic>Infant</topic><topic>Isoantibodies - immunology</topic><topic>Kidney Transplantation - immunology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DALLA VECCHIA, L. K</creatorcontrib><creatorcontrib>BOOK, B. K</creatorcontrib><creatorcontrib>MILGROM, M. L</creatorcontrib><creatorcontrib>JINDAL, R. M</creatorcontrib><creatorcontrib>LEAPMAN, S. B</creatorcontrib><creatorcontrib>FILO, R. S</creatorcontrib><creatorcontrib>PESCOVITZ, M. D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DALLA VECCHIA, L. K</au><au>BOOK, B. K</au><au>MILGROM, M. L</au><au>JINDAL, R. M</au><au>LEAPMAN, S. B</au><au>FILO, R. S</au><au>PESCOVITZ, M. D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive value of enzyme-linked immunosorbent assay-detected IgG anti-HLA antibodies for pediatric renal allograft rejection</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>1997-12-27</date><risdate>1997</risdate><volume>64</volume><issue>12</issue><spage>1744</spage><epage>1747</epage><pages>1744-1747</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><coden>TRPLAU</coden><abstract>Measurement of panel-reactive antibody (PRA) with an enzyme-linked immunosorbent assay using soluble HLA class I molecules (PRA-STAT) in adult renal transplant recipients predicted graft loss and rejection. We sought to confirm this finding in pediatric recipients, an immunologically distinct group.
The population consisted of 158 renal transplants in 146 patients (age range, 1-21 years). PRA was determined with PRA-STAT and microlymphocytotoxicity (CDC), using final cross-match sera. An elevated test was defined as > or =5% reactivity. Statistical analysis for rejection used the chi-square test and for graft survival used the log-rank test.
Thirty-five patients (22%) had %PRA-STAT > or =5%, compared with 26 (16%) with %PRA-CDC > or =5%. The percentage with elevated %PRA-STAT was found to correlate with subsequent transplantations (first, 15%; second, 67%; third, 75%). Subsequent analyses utilized only the 136 primary recipients, of whom 20 (15%) had %PRA-STAT > or =5% and 16 (12%) had %PRA-CDC > or =5%. Elevated %PRA-STAT correlated with rejection at 3 months (65% vs. 36%), 12 months (84% vs. 50%), and 24 months (84% vs. 54%) (P<0.05). No association was found between elevated %PRA-CDC and rejection. Patients with %PRA-STAT > or =5% vs. %PRA-STAT <5% had graft survival at 1 year of 89% vs. 84%, at 2 years of 88% vs. 77%, and at 3 years of 61% vs. 72% (not significant).
Use of %PRA-STAT > or =5% identifies pediatric recipients who are at increased risk for rejection and may benefit from more potent immunosuppression and/or closer monitoring of graft function.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>9422414</pmid><doi>10.1097/00007890-199712270-00021</doi><tpages>4</tpages></addata></record> |
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| ispartof | Transplantation, 1997-12, Vol.64 (12), p.1744-1747 |
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| subjects | Adolescent Adult Biological and medical sciences Child Child, Preschool Enzyme-Linked Immunosorbent Assay Female Graft Rejection - diagnosis Histocompatibility Antigens Class I Humans Immunoglobulin G - immunology Infant Isoantibodies - immunology Kidney Transplantation - immunology Male Medical sciences Prognosis Retrospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system |
| title | Predictive value of enzyme-linked immunosorbent assay-detected IgG anti-HLA antibodies for pediatric renal allograft rejection |
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