Korean J Transplant.  2023 Nov;37(Suppl 1):S207. 10.4285/ATW2023.F-7986.

Panel reactive antibody level according to history of blood transfusion and pregnancy in kidney transplant candidate

• Hwang I
• Park M
• Kim HD
• Kim MH
• Park DJ
• Hwang JK
• Lim J
• Choi BS
• Kim BS
• Ban TH

• KMID: 2551827
• DOI: http://doi.org/10.4285/ATW2023.F-7986

Abstract

Background
Pretransplant sensitization is known as a risk factor for posttransplant antibody-mediated rejection in kidney transplantation (KT). Factors that can cause sensitization include transfusion, pregnancy, and previous transplantation. Panel reactive antibody (PRA) is a useful screening test for pretransplant sensitization. We aim to evaluate the incidence of PRA positivity in KT candidates based on their history of transfusions and pregnancies before transplantation.
Methods
Our institution conducted a study involving a total of 258 patients awaiting KT from April 2019 to July 2023. They had undergone PRA test, and based on their medical records, we divided into four groups: patients with no history of transfusion and pregnancy (group 1, n=153); patients with a history of transfusion only (group 2, n=46); patients with a history of pregnancy only (group 3, n=43); Patients with a history of both transfusion and pregnancy (group 4, n=16). Primary outcome of this study was the proportion or positivity of PRA among the four groups. Secondary outcome was any differences in PRA positivity based on the number of transfusions and pregnancies.
Results
There was a significant difference in the positive rate of PRA between group 1 and group 3 classified according to pregnancy (P<0.001). Even among patients who received blood transfusion, the positive rate of PRA between group 2 and group 4 showed a significant difference according to pregnancy (P<0.001). On the other hand, there was no significant difference in the positive rate of PRA between group 1 and group 2 classified according to transfusion (P=1.000). Among groups 3 and 4 with a history of pregnancy, there was no difference in the positive rate of PRA by blood transfusion (P=0.703).
Conclusions
The proportion of preformed antibody before KT was influenced by the history of pregnancy, but not blood transfusion.