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Author Topic: Difference between PRA and crossmatch
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Post Difference between PRA and crossmatch
on: February 13, 2013, 07:45
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I'm a bit confused about the PRA and the crossmatch.

Say I have a patient with a PRA of 91%. I know that means that the patient will "react" to 91% of the potential donors that are available. Now say that we find a suitable donor (amongst the 9% that don't react to the patient) and that the crossmatch is negative.

Do these results mean that this specific recipient-donor combination is a low-risk transplant because of the negative crossmatch? Does the negative crossmatch basically make the transplant procedure lower risk (despite the 91% PRA)?

Thanks.

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Post Re: Difference between PRA and crossmatch
on: February 14, 2013, 15:40
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Great question.

No the patient is still at high risk for rejection because this recipient has numerous antibodies and the negative crossmatch (which is against donor serum) means there are no antibodies detected in the blood of the recipient that react to donor serum.
Now serum is only a surrogate for the organ, meaning some of the antibodies in recipients serum may react with Donor organ itself, example the endothelium of the kidney.
Also, this person is in general at high risk of making antibodies and although there are no donor specific antibodies at the time of transplant. This patient is high risk of making DSA after the transplant.

Hope this helps.

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