The impact of flow PRA on outcome in pediatric heart recipients in modern era: An analysis of the Pediatric Heart Transplant Study database

B. B. Das, E. Pruitt, K. Molina, W. Ravekes, S. Auerbach, A. Savage, L. Knox, J. K. Kirklin, D. C. Naftel, D. Hsu

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Data from patients in the Pediatric Heart Transplant Study (PHTS) registry transplanted between 2010 and 2014 were analyzed to determine the association between HLA antibody (PRA) determined by SPA using Luminex or flow cytometry with a positive retrospective cross-match and the post-transplant outcomes of acute rejection and graft survival. A total of 1459 of 1596 (91%) recipients had a PRA reported pretransplant; 26% had a PRA > 20%. Patients with a PRA > 20% were more likely to have CHD, prior cardiac surgery, ECMO support at listing, and waited longer for transplantation than patients with a PRA <20%. Patients with higher PRA% determined by SPA were predictive of a positive retrospective cross-match determined by flow cytometric method (P < .001). A PRA > 50% determined by SPA was independently associated with worse overall graft survival after first month of transplant in both unadjusted and adjusted for all other risk factors. In this large multicenter series of pediatric heart transplant recipients, an elevated PRA determined by SPA remains a significant risk factor in the modern era.

Original languageEnglish (US)
JournalPediatric Transplantation
DOIs
StateAccepted/In press - Jan 1 2017

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Databases
Graft Survival
Pediatrics
Transplants
Thoracic Surgery
Registries
Flow Cytometry
Transplantation
Antibodies
Transplant Recipients

Keywords

  • Panel reactive antibody
  • Pediatric heart transplant
  • Sensitization
  • Solid phase assay

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

Cite this

The impact of flow PRA on outcome in pediatric heart recipients in modern era : An analysis of the Pediatric Heart Transplant Study database. / Das, B. B.; Pruitt, E.; Molina, K.; Ravekes, W.; Auerbach, S.; Savage, A.; Knox, L.; Kirklin, J. K.; Naftel, D. C.; Hsu, D.

In: Pediatric Transplantation, 01.01.2017.

Research output: Contribution to journalArticle

Das, B. B. ; Pruitt, E. ; Molina, K. ; Ravekes, W. ; Auerbach, S. ; Savage, A. ; Knox, L. ; Kirklin, J. K. ; Naftel, D. C. ; Hsu, D. / The impact of flow PRA on outcome in pediatric heart recipients in modern era : An analysis of the Pediatric Heart Transplant Study database. In: Pediatric Transplantation. 2017.
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