It's the first question you should ask when pursuing a Kidney Transplant.
When it comes to needing a kidney transplant, most people are thinking about finding a compatible donor. They don’t realize that there is a test you need to take that will determine how easy or difficult it will be to find that person. The test is called PRA.
PRA’s are "panel reactive antibodies.” A blood test measures the level of antibodies in your blood. The more antibodies you have, the more difficult it will be to find a compatible donor. A person's PRA can be anywhere from 0% to 99%. Your PRA represents the percent of the U.S. population that the antibodies in your blood would react negatively to. For example, having a PRA of 25 means that about 25% of the population will not be able to donate a kidney to you. The antibodies present in your blood would attack the transplanted kidney and can cause immediate rejection. About 20% of the people who need a kidney transplant have high PRA’s. Simply stated, having a high PRA will significantly limit the number of people that will be able to donate to you.
You can develop high PRA’s from a blood transfusion, or an earlier transplant, or from being pregnant.
There are ways of lowering PRA’s through a procedure called Plasmapheresis, a blood-cleansing process that can eliminate the dangerous antibodies from the blood. Plasmapheresis is used only in cases in which the patient has a live donor.
Plasmapheresis can also be used to allow blood-type incompatible donor/recipients to proceed with the transplant. Plasmapheresis can cost tens of thousands of dollars more than conventional transplants and are complex to administer.
If you’ve been told by a transplant center that you are too highly sensitized (another term used to describe high PRA's) to receive a transplant, ask about Plasmapheresis. If they don’t offer it there, speak to another transplant center.