Comparison of PRA-STAT, sHLA-EIA, and anti-human globulin-panel reactive antibody to identify alloreactivity in pretransplantation sera of heart transplant recipients: Correlation to rejection and posttransplantation coronary artery disease

R. H. Kerman, B. Susskind, D. Kerman, M. Lam, K. Gerolami, J. Williams, R. Kalish, M. Campbell, S. Katz, C. T. Van Buren, H. Frazier, B. Radovancevic, S. Fife, B. Kahan

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Background: Screening pretransplantation recipient sera for percent panel reactive antibodies (%PRA) by an anti-human globulin (AHG) assay may identify recipients who are at risk for graft rejection or development of posttransplantation coronary artery disease. However, the pretransplantation AHG-%PRA does not always correlate with the occurrence of graft rejection or coronary artery disease. Methods: We compared the predictive capacity of the AHG-%PRA with that of an enzyme-linked immunoassay (EIA)-based PRA assay that identifies immunoglobulin G bound to soluble human leukocyte antigen (sHLA) class I molecules from pooled platelets of 240 random donors (sHLA-EIA), and that of an EIA-based assay that detects immunoglobulin G anti-HLA class I antibodies bound to sHLA derived from individual HLA-typed cell cultures (PRA-STAT). The pretransplantation sera from 130 cardiac allograft recipients were comparatively tested and results evaluated. Results: Although AHG-%PRA- and sHLA-EIA-determined PRA results were comparable, neither assay discriminated potential recipients at risk for rejection or coronary artery disease. However, cardiac allograft recipients with pretransplantation PRA- STAT sera > 10% were at risk for (1) graft rejection (77% vs 56%, p < .05); (2) more rejections/recipient (1.9 vs 1.0, p < .02); (3) graft rejection within 30 days (92% vs 38%, p < .001); or (4) development of coronary artery disease (48% vs 23%, p < .05) than recipients with pretransplantation PRA- STAT sera < 10%. Conclusions: PRA-STAT analysis of pretransplantation sera from potential cardiac allograft recipients may be more clinically informative about HLA alloimmunity and a better predictor of adverse clinical events than either AHG-%PRA- or sHLA-EIA-determined PRA.

Original languageEnglish (US)
Pages (from-to)789-794
Number of pages6
JournalJournal of Heart and Lung Transplantation
Volume17
Issue number8
StatePublished - 1998

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

Fingerprint Dive into the research topics of 'Comparison of PRA-STAT, sHLA-EIA, and anti-human globulin-panel reactive antibody to identify alloreactivity in pretransplantation sera of heart transplant recipients: Correlation to rejection and posttransplantation coronary artery disease'. Together they form a unique fingerprint.

  • Cite this

    Kerman, R. H., Susskind, B., Kerman, D., Lam, M., Gerolami, K., Williams, J., Kalish, R., Campbell, M., Katz, S., Van Buren, C. T., Frazier, H., Radovancevic, B., Fife, S., & Kahan, B. (1998). Comparison of PRA-STAT, sHLA-EIA, and anti-human globulin-panel reactive antibody to identify alloreactivity in pretransplantation sera of heart transplant recipients: Correlation to rejection and posttransplantation coronary artery disease. Journal of Heart and Lung Transplantation, 17(8), 789-794.