Pre-transplantation PRA antibody detection

The effects of antibodies in the transplant recipient and the screening technologies have drawn the clinicians’ attention since the early days of kidney transplantation(the 1960s). At first, the preexisting circulating antibodies were found to be the leading cause of hyperacute rejection reactions. Therefore, lymphocytotoxicity cross matching tests were routinely used as a method for preoperative antibody screening.

Studies since the 1990s have shown that these circulating antibodies include IgG antibodies, IgM antibodies, IgA antibodies as well as autoantibodies, and it is only the IgG antibodies (mainly anti-HLA-Class I and Class II IgG antibodies) that affect transplant survival and rejection reactions.

Meanwhile, antibody screening and detecting technologies developed from the conventional complement-dependent cytotoxicity(CDC)  assay  to enzyme-linked immunosorbent assay(ELISA) and from screening circulating antibodies to detecting specific anti-HLA-IgG antibodies.

Anti-HLA antibody level indicator-PRA

PRA——Panel reactive antibody, the HLA antibody level in the transplant recipient.

Sensitization level: Unsensitized 0-10%

Low sensitization 11-50%

Moderate sensitization 51-80%

High sensitization ＞81%

Sensitization factors: Transfusion, pregnancy, transplantation, and other diseases, etc.

PRA detection clinical application

Choose transplant organ and time of operation according to the PRA level and specificity of the recipient.

HLA typing is necessary for highly sensitized recipients.

Cross matching is necessary for positive PRA before transplantation.

Post-transplant PRA monitoring helps to determine the immune state, guide the use of immunosuppressant and adjust the immunotherapy protocol.

PRA ELISA Assay Kit

PRA luminex assay kit