1.2000
#20
THE SIGNIFICANCE OF PRE- AND POST-TRANSPLANT ELISA-PRA IN PREDICTING EARLY ACUTE REJECTION EPISODES.
Fernanda Ribas, Maria da Graca Bicalho, Ricardo Benvenutti and Fabiana Contieri. Curitiba Parana, Brazil, Universidade Federal do Parana, 81531-990, Genetics and Curitiba Parana, Brazil, Universidade Evangelica, Renal Transplant Unit.
Preformed antibodies against HLA donor antigens producing an instantaneous hyperacute rejection are well established, but the involvement of alloantibodies or even preformed antibodies in early acute rejection (EAR) remains unclear. This study intend to correlate the pre- and pos- transplant (Tx) ELISA-PRA and the incidence of EAR in 50 renal recipients transplanted at the Renal Transplant Unit, University Evangelic, Brazil. Patients were classified in 3 groups: (1) zero EAR, (2) one EAR, (3) two or three EAR. Fifty pre-Tx and 49 post-Tx serum samples were screened for the detection of IgG antibody to HLA Class I and II antigens by ELISA-PRA using LATM Kit (One Lambda). Serum samples with positive prescreening results were also analyzed by LAT1240 Kit (One Lambda) to identify antibody specificities. The chi-square test revealed no significant differences among the groups concerning sera prescreening. Only one patient from group 1 and one from group 2 maintained their PRA positive on post-Tx prescreening. The first patient displayed a 93% PRA suggesting antibodies against HLA public epitopes; and the second a 50% pre-Tx PRA and 32% post-Tx PRA, both detecting anti-Bw4. In the third group two patients displayed a positive prescreening, but the LAT1240 analysis provided 0% pre- and post-Tx PRA for one patient and 33% for the other, detecting anti-DR4 antibody in the last case, specificity founded in the HLA donor typing. Anti-HLA antibodies were not clearly detected in patients showing post-Tx disorders and the results found in these 3 groups were discrepant, suggesting that the proposed methodology is not a good predictor of EAR episodes.