Cooper T Y, Jordan C L, Willimon C M, Land G A
Histocompatibility Laboratory, Stewart Regional Blood Center, Tyler, Texas 75701, USA.
Transplantation. 1995 Aug 27;60(4):327-30. doi: 10.1097/00007890-199508270-00004.
PRA levels from 58 Caucasian and 70 African American ESRD patients were compared against a panel of cryopreserved lymphocytes from 60 donors (40 Caucasian, 15 African American, 5 others) to determine whether there was significant racial influence on PRA outcome. African Americans were found to have significantly higher mean PRA levels than Caucasians (27% vs. 18%, P = 0.02). Restricting this analysis to only 1 degree transplant candidates showed predictably lower mean PRAs: 6% in Caucasians and 15% in African Americans, but the difference between the two groups remained significant (P = 0.015). The percentage of patients with PRA > or = 10% was also greater among African Americans than Caucasians (43% vs. 24%, P = 0.026). For patients not previously transplanted, the difference between these frequencies remained significant: 11% in Caucasians, 30% in African Americans (P = 0.025). Untransplanted African American patients with positive PRAs (> or = 10%) had significantly higher PRA against African American cell donors (mean = 55%) than against Caucasian cell donors (mean = 44%) (mean difference = 10.6%, P = 0.0056). African Americans were more frequently transfused than Caucasians. The percentage of patients not previously transplanted receiving 0, 1-5, and > 5 transfusions were 69%, 22%, and 9% for Caucasians and 43%, 44%, and 13% for African Americans (P = 0.03). This higher transfusion rate is the most likely contributor to the elevated PRA levels observed in African Americans.
将58名白种人和70名非裔美国终末期肾病（ESRD）患者的群体反应性抗体（PRA）水平与一组来自60名供者（40名白种人、15名非裔美国人、5名其他种族）的冷冻保存淋巴细胞进行比较，以确定种族对PRA结果是否有显著影响。结果发现，非裔美国人的平均PRA水平显著高于白种人（27%对18%，P = 0.02）。将该分析仅限于一级移植候选者时，平均PRA水平可预见地更低：白种人为6%，非裔美国人为15%，但两组之间的差异仍然显著（P = 0.015）。PRA≥10%的患者百分比在非裔美国人中也高于白种人（43%对24%，P = 0.026）。对于既往未接受过移植的患者，这些频率之间的差异仍然显著：白种人为11%，非裔美国人为30%（P = 0.025）。PRA呈阳性（≥10%）的未移植非裔美国患者对非裔美国细胞供者的PRA显著高于对白种人细胞供者的PRA（平均值 = 55%对平均值 = 44%）（平均差异 = 10.6%，P = 0.0056）。非裔美国人比白种人更频繁地接受输血。既往未接受过移植的患者接受0次、1 - 5次和>5次输血的百分比，白种人分别为69%、22%和9%，非裔美国人分别为43%、44%和13%（P = 0.03）。这种更高的输血率最有可能是导致在非裔美国人中观察到的PRA水平升高的原因。
