Association of Panel Reactive Antibodies (PRA) with Complement Dependent Cytotoxicity (CDC) Cross-Match in Pre-Renal Transplant Recipients

  • Dr. Muhammad Hussain Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Muhammad Mukarram Bashir Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Hamid Nawaz Tipu Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Muhammad Dawood Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Noor Afshan Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Ayesha Arooj Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
Keywords: Complement dependent cytotoxicity (CDC) cross-match, Major histocompatibility complex (MHC) class l related chain, Panel reactive antibodies (PRA), Renal transplant

Abstract

Objective: To determine the association of panel reactive antibodies (PRA) with complement-dependent cytotoxicity (CDC) cross-match in Pakistani pre-renal transplant recipients.

Study Design: Cross-sectional study.

Place and Duration of Study: Immunology Department, Armed Forces Institute of Pathology, Rawalpindi from Oct 2017 to Oct 2018.

Methodology: A total of 162 patients referred to the Department of Immunology for pre-transplant workup for renal transplantation were included. Informed consent was taken, and detailed history was recorded. Frequency and percentages were calculated for cross-match positivity and most frequent anti-HLA antibodies.

Results: Panel reactive antibodies (PRA) were present in 48 patients (30%), while complement-dependent cytotoxicity (CDC) cross-match was positive in 16 patients (10%). Out of 141 male patients, 35 (25%) were positive for PRA, while 10 (7%) had positive CDC cross-match. Out of 21 female recipients, 13 (62%) were positive for PRA, and 6 (28%) had positive CDC crossmatch. One male patient positive for CDC cross-match was negative for PRA. Patients positive for both CDC cross-match and PRA have an average mean fluorescent intensity (MFI) of more than 4000. CDC cross-match and PRA were strongly associated, whereas no significant association was found between CDC cross-match and anti-MIC antibodies.

Conclusion: Complement dependent cytotoxicity (CDC) cross-match and panel reactive antibodies (PRA) should be routine in patients undergoing renal transplants as alone CDC cross-match can give false negative or false-positive results. At the same time, CDC cross-match lacks detection of anti MIC antibodies involved in graft rejection.

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Published
2022-05-01
How to Cite
Hussain, D. M., Bashir, M., Tipu, H., Dawood, M., Afshan, N., & Arooj, A. (2022). Association of Panel Reactive Antibodies (PRA) with Complement Dependent Cytotoxicity (CDC) Cross-Match in Pre-Renal Transplant Recipients. PAFMJ, 72(2), 509-12. https://doi.org/10.51253/pafmj.v72i2.4810
Section
Original Articles