EFFECT OF HUMAN RECOMBINANT ERYTHROPOIETIN THERAPY ON PANEL REACTIVE ANTIBODIES IN CHRONIC DIALYSIS PATIENTS

To examine whether recombinant human erythropoietin (rhEPO) therapy re sults in decreased presensitization to foreign HLA antigens, we retros pectively analyzed data from 64 of 200 patients treated in a universit y hospital dialysis center between 1985 and 1995 who had undergone rou tine panel reactive antibody (PRA%) screening. Though a significant de crease in the annual frequency of highly sensitized patients over the years was noted, 16 patients followed for 27.1+/-3.7 months after init iation of rhEPO therapy until transplantation or blood transfusion sho wed no significant overall decrease in PRA%. Six highly presensitized patients had moderate but significant overall decrease in PRA%. Howeve r, in three of these patients the. PRA% was unchanged and in the other three patients the PRA% remained over 50%. Thus rhEPO therapy reduced the incidence of highly presensitized patients, but previously presen sitized patients remained presensitized. We conclude that removal of t ransfusional stimulation of lymphocytotoxic antibody production does n ot appear to benefit previously presensitized patients, possibly due t o the maintenance of B-lymphocyte clonal expansion by unknown factors, or even by rhEPO itself.