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calculated panel reactive antibodies

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https://www.readbyqxmd.com/read/28372890/performance-evaluation-of-the-point-of-care-insti%C3%A2-hiv-1-2-antibody-test-in-early-and-established-hiv-infections
#1
Sarah Adams, Wei Luo, Laura Wesolowski, Stephanie E Cohen, Philip J Peters, S Michele Owen, Silvina Masciotra
BACKGROUND: The flow-through INSTI™ HIV-1/HIV-2 Rapid Antibody (INSTI) test is a 60s FDA-approved test for HIV-1 and HIV-2 antibody testing using whole blood and plasma. OBJECTIVE: We evaluated the performance of INSTI using plasma and simulated whole blood specimens. STUDY DESIGN: INSTI's performance in plasma specimens from commercial seroconversion panels was assessed by estimating the relative sensitivity using a 50% cumulative frequency analysis and by comparing its performance with other FDA-approved rapid tests (RTs)...
March 23, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28348361/the-impact-of-donor-specific-anti-human-leukocyte-antigen-hla-antibody-rebound-on-the-risk-of-antibody-mediated-rejection-in-sensitized-kidney-transplant-recipients
#2
Kyo Won Lee, Jae Berm Park, Chan Woo Cho, Nuri Lee, Heejin Yoo, Kyunga Kim, Hyojun Park, Eun Suk Kang, Wooseong Huh, Sungjoo Kim
BACKGROUND Donor-specific anti-HLA antibody (DSA) detected on Luminex-based single antigen assay (LSA) has become the subject of desensitization based upon the results of previous studies. We retrospectively investigated the impact of preoperative DSA on the incidence of antibody mediated rejection (AMR) in patients desensitized using a protocol based on rituximab and rabbit antithymocyte globulin (rATG). MATERIAL AND METHODS Nine patients (Group 1, 9/327, 2.8%) were complement dependent cytotoxicity crossmatch (CDC-XM) positive and underwent desensitization with rituximab (375 mg/m²), intravenous immunoglobulin (IVIG; 400 mg/kg), plasmapheresis, and rATG...
March 28, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28340809/corrected-panel-reactive-antibody-positivity-rates-for-hypersensitized-patients-in-turkish-population-with-calculated-panel-reactive-antibody-software
#3
S T Karadeniz, S U Akgul, Y Ogret, H S Ciftci, A Bayraktar, H Bakkaloglu, Y Caliskan, K Yelekci, A Turkmen, A E Aydin, F S Oguz, M Carin, F Aydin
INTRODUCTION: High rates of panel-reactive antibody (PRA) may decrease the chance of kidney transplantation and may result in long waiting periods before transplantation. The calculated PRA (cPRA) is performed based on unacceptable HLA antigens. These antigens are identified by a program that was created based on the antibodies that developed against the HLA antigens circulating in serum and on the risk of binding of these antibodies to antigens. The antigen profile of the population and antigen frequencies can be measured, and more realistic cPRA positivity rates may be obtained using this method...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340245/unacceptable-human-leucocyte-antigens-for-organ-offers-in-the-era-of-organ-shortage-influence-on-waiting-time-before-kidney-transplantation
#4
Malte Ziemann, Nicole Heßler, Inke R König, Nils Lachmann, Andrea Dick, Vanessa Ditt, Klemens Budde, Petra Reinke, Ute Eisenberger, Barbara Suwelack, Thomas Klein, Timm H Westhoff, Wolfgang Arns, Katrin Ivens, Antje Habicht, Lutz Renders, Dirk Stippel, Dominik Bös, Florian Sommer, Siegfried Görg, Martin Nitschke, Thorsten Feldkamp, Falko M Heinemann, Reinhard Kelsch
Background.: The assignment of human leucocyte antigens (HLAs) against which antibodies are detected as unacceptable antigens (UAGs) avoids allocation of HLA- incompatible allografts. There is uncertainty as to what extent UAGs decrease the probability of receiving a kidney offer. Methods.: Kidney transplantations in 3264 patients on the waiting lists of six German transplant centres were evaluated for a period of at least 2 years. The proportion of excluded offers due to UAGs was calculated as virtual panel-reactive antibodies (vPRAs)...
March 15, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28318744/calculated-panel-reactive-antibody-predicts-outcomes-on-the-heart-transplant-waiting-list
#5
Evan P Kransdorf, Michelle M Kittleson, Jignesh K Patel, Marcelo J Pando, D Eric Steidley, Jon A Kobashigawa
BACKGROUND: Sensitized heart transplant candidates spend more time and have higher mortality on the waiting list. Although the calculated panel-reactive antibody (CPRA) value is used to assign allocation priority to kidney transplant candidates in the United States, the relationship between CPRA and outcomes on the heart transplant waiting list is unknown. METHODS: A data set of patients listed for heart transplant with unacceptable human leukocyte antigens (HLA) entered was obtained from the United Network for Organ Sharing...
February 17, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28284304/kidney-paired-exchange-and-desensitization-strategies-to-transplant-the-difficult-to-match-kidney-patients-with-living-donors
#6
REVIEW
Thomas A Pham, Jacqueline I Lee, Marc L Melcher
With organs in short supply, only a limited number of kidney transplants can be performed a year. Live donor donation accounts for 1/3rd of all kidney transplants performed in the United States. Unfortunately, not every donor recipient pair is feasible because of Human leukocyte antigen (HLA) sensitization and ABO incompatibility. To overcome these barriers to transplant, strategies such as kidney paired donation (KPD) and desensitization have been developed. KPD is the exchange of donors between at least two incompatible donor-recipient pairs such that they are now compatible...
January 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28245084/donor-specificity-but-not-broadness-of-sensitization-is-associated-with-antibody-mediated-rejection-and-graft-loss-in-renal-allograft-recipients
#7
C Wehmeier, G Hönger, H Cun, P Amico, P Hirt-Minkowski, A Georgalis, H Hopfer, M Dickenmann, J Steiger, S Schaub
Panel-reactive antibodies are widely regarded as an important immunological risk factor for rejection and graft loss. The broadness of sensitization against HLA is most appropriately measured by the "calculated population-reactive antibodies" (cPRA) value. In this study, we investigated whether cPRA represent an immunological risk in times of sensitive and accurate determination of pretransplantation donor-specific HLA antibodies (DSA). Five hundred twenty-seven consecutive transplantations were divided into four groups: cPRA 0% (n = 250), cPRA 1-50% (n = 129), cPRA 51-100% (n = 43), and DSA (n = 105)...
February 28, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28164503/association-of-hla-types-with-non-specific-binding-of-negative-control-beads-in-luminex-panel-reactive-antibody-pra-screening-assay
#8
Nuri Lee, Hee Sue Park, Ji Won In, Eun Youn Roh, Sue Shin, Kyoung Un Park, Eun Young Song
BACKGROUND: Luminex panel reactive antibody (PRA) screening assays using microbeads are widely used for organ transplantation. Anti-HLA serum reactivity is calculated by correcting for non-specific binding to the negative control (NC) beads. High mean fluorescence intensity (MFI) value of NC beads are observed in some patients and can result in false negative results in the PRA screening assay. We analyzed the clinical characteristics and HLA types of those patients with high MFI values of NC beads...
January 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28162932/multicenter-evaluation-of-a-national-organ-sharing-policy-for-highly-sensitized-patients-listed-for-heart-transplantation-in-canada
#9
Brian Clarke, Anique Ducharme, Nadia Giannetti, Daniel Kim, Michael McDonald, Peter Pflugfelder, Miroslaw Rajda, Mario Sénéchal, Ellie Stadnick, Mustafa Toma, Shelley Zieroth, Debra Isaac
BACKGROUND: Transplantation of sensitized recipients has been associated with increased risk of post-transplant complications. In 2010, the Canadian Cardiac Transplant Network (CCTN) created a unique status listing for highly sensitized heart transplant candidates. Status 4S listing requires calculated panel-reactive antibody (cPRA) level >80% as the sole listing criteria and enables geographic expansion of the donor pool by providing national access. In this study, we describe patient characteristics and outcomes of those transplanted as Status 4S in Canada...
May 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28086979/b-cell-repertoires-in-hla-sensitized-kidney-transplant-candidates-undergoing-desensitization-therapy
#10
John F Beausang, H Christina Fan, Rene Sit, Maria U Hutchins, Kshama Jirage, Rachael Curtis, Edward Hutchins, Stephen R Quake, Julie M Yabu
BACKGROUND: Kidney transplantation is the most effective treatment for end-stage renal disease. Sensitization refers to pre-existing antibodies against human leukocyte antigen (HLA) protein and remains a major barrier to successful transplantation. Despite implementation of desensitization strategies, many candidates fail to respond. Our objective was to determine whether measuring B cell repertoires could differentiate candidates that respond to desensitization therapy. METHODS: We developed an assay based on high-throughput DNA sequencing of the variable domain of the heavy chain of immunoglobulin genes to measure changes in B cell repertoires in 19 highly HLA-sensitized kidney transplant candidates undergoing desensitization and 7 controls with low to moderate HLA sensitization levels...
January 13, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28069404/calculated-panel-reactive-antibody-with-decimals-a-refined-metric-of-access-to-transplantation-for-highly-sensitized-candidates
#11
Evan P Kransdorf, Marcelo J Pando
The use of the calculated panel reactive antibody (CPRA) value and the implementation of allocation points for sensitized candidates by the United Network for Organ Sharing (UNOS) have improved access to kidney transplantation for highly sensitized candidates (98% CPRA and above). Despite this, a large population of highly sensitized candidates remain awaiting transplantation. To better define this population, we propose the use of two refinements of the standard UNOS CPRA, the CPRA with decimals or CPRAd, and the likelihood of a compatible donor (LCD)...
March 2017: Human Immunology
https://www.readbyqxmd.com/read/28052609/optn-srtr-2015-annual-data-report-kidney
#12
A Hart, J M Smith, M A Skeans, S K Gustafson, D E Stewart, W S Cherikh, J L Wainright, A Kucheryavaya, M Woodbury, J J Snyder, B L Kasiske, A K Israni
The first full year of data after implementation of the new kidney allocation system reveals an increase in deceased donor kidney transplants among black candidates and those with calculated panel-reactive antibodies 98%-100%, but a decrease among candidates aged 65 years or older. Data from 2015 also demonstrate ongoing positive trends in graft and patient survival for both deceased and living donor kidney transplants, but the challenges of a limited supply of kidneys in the setting of increasing demand remain evident...
January 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28009780/kidney-transplant-with-low-levels-of-dsa-or-low-positive-b-flow-crossmatch-an-underappreciated-option-for-highly-sensitized-transplant-candidates
#13
Carrie Schinstock, Manish Gandhi, Wisit Cheungpasitporn, Donald Mitema, Mikel Prieto, Patrick Dean, Lynn Cornell, Fernando Cosio, Mark Stegall
BACKGROUND: Avoiding donor specific antibody (DSA) is difficult for sensitized patients. Improved understanding of the risk of low level DSA is needed. METHODS: We retrospectively compared the outcomes of 954 patients transplanted with varied levels of baseline DSA detected by single antigen beads and B flow cytometric crossmatch (XM). Patients were grouped as follows: -DSA/-XM, +DSA/-XM, +DSA/low+XM, +DSA/high+XM, and -DSA/+XM and followed for a mean of 4.1±1...
December 22, 2016: Transplantation
https://www.readbyqxmd.com/read/27988992/outcomes-in-the-highest-panel-reactive-antibody-recipients-of-deceased-donor-kidneys-under-the-new-kidney-allocation-system
#14
Sandesh Parajuli, Robert R Redfield, Brad C Astor, Arjang Djamali, Dixon B Kaufman, Didier A Mandelbrot
Since the institution of the new kidney allocation system in December 2014, kidney transplant candidates with the highest calculated panel reactive antibodies (cPRA) of 99-100 have been transplanted at much higher rates. However, concerns have been raised that outcomes in these patients might be impaired due to higher immunological risk and longer cold ischemia times resulting from long-distance sharing of kidneys. Here, we compare outcomes at the University of Wisconsin between study patients with cPRA 99-100 and all other recipients of deceased donor kidneys transplanted between 12/04/2014 and 12/31/2015...
December 17, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27955974/increased-access-to-transplantation-of-highly-sensitized-patients-under-the-new-kidney-allocation-system-a-single-center-experience
#15
Adriana I Colovai, Maria Ajaimy, Layla G Kamal, Peter Masiakos, Shirley Chan, Christina Savchik, Michelle Lubetzky, Graciela de Boccardo, Alesa Courson, Attasit Chokechanachaisakul, Jay Graham, Stuart Greenstein, Milan Kinkhabwala, Juan Rocca, Enver Akalin
We aimed to investigate the impact of the new kidney allocation system (KAS) on the rate of transplantation of sensitized patients at our center. Pre-KAS and post-KAS intervals were Jan 1st to Dec 3rd 2014 and Jan 1st 2015 to Dec 3rd 2015, respectively. The number of deceased-donor crossmatches performed by flow cytometry increased from 715 pre-KAS to 1188 post-KAS. The percent of crossmatches performed for sensitized patients with calculated panel reactive antibody (cPRA)>0% increased from 19% pre-KAS to 26% post-KAS (p<0...
March 2017: Human Immunology
https://www.readbyqxmd.com/read/27932102/kidney-transplantation-results-in-very-highly-sensitized-patients-included-in-a-virtual-crossmatch-program-analysis-of-kidney-pairs
#16
MULTICENTER STUDY
A Mazuecos, A Alvarez, A Nieto, M A Gentil, M Cabello, A Rodriguez-Benot, C Gracia, F Gonzalez, P Castro, M Alonso
BACKGROUND: Kidney transplantation in highly-sensitized (HS) patients can improve with organ-exchange strategies based on virtual crossmatch (V-XM). Experience in very-HS patients is limited. METHODS: In June 2012, Andalusia started a V-XM protocol for very-HS patients (calculated panel reactive antibodies ≥95%). After organ allocation a cytotoxic-XM performed immediately before transplantation had to be negative for surgery to proceed. We analyzed results up until December 2015...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932095/implementation-of-a-national-priority-allocation-system-for-hypersensitized-patients-in-spain-based-on-virtual-crossmatch-initial-results
#17
M O Valentin, J C Ruiz, R Vega, C Martín, R Matesanz
Access to kidney transplantation for patients with high levels of antibodies against HLA is a major challenge. This issue makes it difficult to detect compatible donors for those patients in a certain geographical area. Consequently, hypersensitized patients remain on the waiting list for long periods and their quality of life deteriorates. Our purpose was to increase access to transplantation for highly sensitized patients by developing a national priority allocation system based on virtual crossmatch. Between June 15, 2015, and May 15, 2016, 675 patients on the kidney transplant waiting list with calculated panel-reactive antibodies ≥98% and undergoing dialysis for at least 12 months were included in the study; 86...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27890719/casting-a-smaller-net-into-a-bigger-donor-pool-a-single-center-s-experience-with-the-new-kidney-allocation-system
#18
Julie A Houp, Karl P Schillinger, Andrew J Eckstein, Renato M Vega, Niraj M Desai, Bonnie E Lonze, Annette M Jackson
The new kidney allocation system (KAS) provides additional allocation points for candidates with broad HLA sensitization in an effort to increase transplant rates for this underserved population. Following the implementation of KAS, our center lowered the HLA antibody threshold for listing unacceptable antigens from a cytotoxicity crossmatch level to a flow cytometric crossmatch level increasing Calculated Panel Reactive Antibody (CPRA) values and allocation points, yet restricting acceptable donor HLA phenotypes...
January 2017: Human Immunology
https://www.readbyqxmd.com/read/27854236/correlation-of-bk-virus-neutralizing-serostatus-with-the-incidence-of-bk-viremia-in-kidney-transplant-recipients
#19
Johanna R Abend, Marguerite Changala, Atul Sathe, Fergal Casey, Amy Kistler, Sindhu Chandran, Abigail Howard, David Wojciechowski
BACKGROUND: BK virus (BKV)-associated nephropathy is the second leading cause of graft loss in kidney transplant recipients. Due to the high prevalence of persistent infection with BKV in the general population, it is possible that either the transplant recipient or donor may act as the source of virus resulting in viruria and viremia. Although several studies suggest a correlation between donor-recipient serostatus and the development of BK viremia, specific risk factors for BKV-related complications in the transplant setting remain to be established...
June 1, 2016: Transplantation
https://www.readbyqxmd.com/read/27801681/immunological-effect-of-skin-allograft-in-burn-treatment-impact-on-future-vascularized-composite-allotransplantation
#20
Rebecca M Garza, Barry H Press, Dolly B Tyan, Yvonne L Karanas, Gordon K Lee
Skin allografts are the gold standard in temporary burn wound coverage, but allografts are hypothesized to place a high antigenic load on recipients. This project aims to determine the degree of human leukocyte antigen sensitization in burn patients treated with allografts. Serum was obtained from nine adult, nontransfused, and nontransplanted burn patients treated with allografts. Group 1 included patients tested in the acute burn period, while group 2 included different patients tested months to years after injury...
May 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
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