Original articles: General thoracicInfluence of panel-reactive antibodies on posttransplant outcomes in lung transplant recipients
Section snippets
Material and methods
We retrospectively reviewed the records of the first 200 lung transplant operations (performed at Duke University Medical Center between November 1992 and December 1998) and identified all patients with a PRA screen of greater than 10% before transplantation. The technique for determining PRA during this study was the complement-dependent cell cytotoxicity (CDC) test. Briefly, a panel of T-cell-enriched lymphocytes from donors of known HLA types is screened with recipient sera using the
Results
Clinical outcomes are shown in Table 1. Of the 200 lung transplants performed between November 1992 and December 1998, 18 (9%) were in patients with at least one pretransplant PRA screen of greater than 10%. The mean PRA, donor, and recipient ages, gender, race, and underlying disease of sensitized and nonsensitized patients are shown in Table 2.
Comment
Decreased kidney graft survivals have been reported in recipients with pretransplant circulating antibodies 10, 11. In cardiac transplants, Kobashigawa and colleagues [5] found elevated PRA correlated with decreased 3-year survival, earlier episodes of rejection, and more severe rejections. In liver transplants, elevated PRA correlated with early severe rejection episodes and graft failure [2].
In comparison, Gammie and colleagues [6] found elevated PRA did not predict decreased survival or the
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