I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: GoingThere on January 04, 2011, 03:09:53 AM
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Hi!
Can you tell me, what importance does PRA play in context of transplant waiting time? I have PRA 0 %.
Tnx,
GT
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Hi Uros, PRA (panel reactive antibodies) is a measure of how many antibodies you have built up in your system. If a donor has a specific antigen and you have an antibody to that antigen, your system will reject the kidney in most circumstances. Normally, we speak of antibodies in terms of disease and building up antibodies is considered the sign of a strong immune system and very positive. But if you think like a transplant patient, antibodies are bad. PRA is a measure of what percentage of the population you are sensitized to - what percentage of the population cannot donate to you because your system would reject the kidney. Every donor, living or deceased, will have their blood crossmatched against yours to check for sensitization a few hours or days before the transplant takes place. Again, you have to think a little backwards: positive crossmatch is bad, negative crossmatch is what you want.
Your PRA is the best value to have, so you won't have to wait longer due to that. PRA increases with blood transfusions, pregnancy, and previous transplant - any time your blood mixes with another person's. Since I know you have not had two of the three, your primary concern should be on avoiding blood transfusions by trying to keep your lab values where they need to be (especially hemoglobin and red blood cell count). If you must have a blood transfusion, and sometimes it is life or death and you have to go for the lesser evil, then try to request leukocyte depleted and irradiated blood. This is expensive stuff. I would talk about how to make sure you can get 'clean' blood with your doctors so that you don't have to have this conversation in an emergency.
Hope that helps!
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Just know zero is good!
:yahoo;
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Rerun could not have said it better!!!! yaaaaaa for 0% :bandance;
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0% is incredible!! Good for you!! It will help in getting your transplant sooner. One less thing for you to worry about. :yahoo;
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In the U.S., when one's PRA is very high, she or he has a priority to get a kidney, but fewer kidneys can be matched. Most likely, the waiting time is longer with higher PRA, but one can be lucky once a matched kidney comes by, the priority kicks in.
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I had a PRA of 0% but obviously now mine will be higher. I wonder if they've tested mine since to figure out. At one point some wanted to give me a blood transfusion because my Hb was low (72) but I said no way (it would raise the PRA even more...) and luckily the senior docs agreed and we waited and sure enough now I'm up to 107 and slowly rising, so I didn't need it afterall.
I know that the next time I need a transplant (decades away, hopefully!) it will be harder having a non-zero PRA, but hey it's worth it to have Danny in me right now.
GT you are in the best position to get a transplant with 0%!
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:cheer: YAY for a zero!