Comparison of the results of PRA identification and Single antijen Bead assay in patients with Kidney Transplant Candidate.

Abstract

We aimed to compare the results of Single Antigen Bead (SAB) and Panel reactive antibody (PRA) class‐I‐II identification of the end‐stage renal disease patients. We retrospectively analyzed 256 patients (female/male,152/104) who were tested for anti‐HLA antibodies the years between 2017 and 2020. PRA identification and SAB tests were performed by using an Luminex method (immucor). Patients were classified as positive for PRA (MFI≥1000) (78%) and positive for SAB (37.2%) according to anti HLA antibodies. 39.6% of patients with PRA (+) and 33.3% of patients with SAB (+) had ‘’Donor Spesific Antibody’’(DSA). Anti‐HLA antibodies of the patients who had DSA with high MFI were as follows: A1 (16913), A2 (15715), B50 (9207), B51 (6000), DR15 (20000), DR16 (16350), DQ7 (22700), DQ2 (22400). Of the PRA (+) patients, 20% were only class‐I (+); 40% were only class‐II (+); 40% were both class‐I‐II (+). PRA (+) patients were divided into 4 groups according to their MFI values as follows: Group‐1: MFI <1000, Group‐2: MFI:1000‐3000, Group‐3: MFI:3000‐5000, Group‐4: MFI>5000. Class‐I‐SAB was performed in 106 of patients with PRA‐class‐I (+). Class‐I‐SAB was positive in 80%, 83%, 100% and 98% of patients in groups respectively. Class‐II‐SAB was performed in 160 of the PRA‐class‐II (+) patients. Class‐II‐SAB was positive in 57,1%, 54,5%, 77,7% and 89% of patients in groups respectively. Our results indicated that the PRA‐class‐I MFI values above 3000 were associated with Class‐I‐SAB positivity (p:0,049) and PRA‐class‐II MFI values above 5000 were associated with Class‐II‐SAB positivity (p:0,0001).