Although Ezell claims that we only “repackaged in a new article the limitations identified by Ezell et al. of PRA in terrorism risk analysis,” he neither addresses nor refutes any of our substantive technical points and examples, and his comments reflect a fundamental lack of understanding of our main ideas. We are therefore grateful for this opportunity to clarify our reasoning in light of his...

Putative antibody-mediated rejection (AMR) in HLA-identical sibling transplantation has rarely been reported and occurred before routine calcineurin inhibitor use. A 29-year-old male developed allograft dysfunction following an HLA-identical renal transplant from his sibling. A pretransplant panel-reactive antibody (PRA) was elevated, pre-transplant crossmatch was negative and no donor-specific...

BACKGROUND AND OBJECTIVE The risk of graft loss after pediatric kidney transplantation increases during late adolescence and early adulthood, but the extent to which this phenomenon affects all recipients is unknown. This study explored interactions between recipient factors and this high-risk age window, searching for a recipient phenotype that may be less susceptible during this detrimental a...

The development of new highly sensitive, specific technologies to detect HLA antibodies has allowed a better definition of the profile of non-permitted antigens for patients awaiting kidney transplantation. The use of calculated or virtual panel reactive antibodies (CPRA or vPRA) seeks to improve the prediction of positive crossmatches (XM), but increases the proportion of sensitized patients o...

BACKGROUND An organ-sharing system should achieve fairness and optimal graft longevity. Balancing between social and utilitarian considerations is a sensitive ethical, public and medical issue that requires a means to examine the consequences of any allocation policy or planned changes thereof. OBJECTIVE To evaluate the performance and applicability of a computerized simulation model by exami...

The effects of the catecholestrogen 2-hydroxyestradiol (250 and 500 micrograms/day, each for 7 days) on plasma renin substrate (PRS), activity (PRA) and concentration (PRC) were studied in male rats as compared with those of estradiol (250 micrograms/day, for 7 days) and vehicle alone (for 7 days). Pre-treatment levels of PRS, PRA, PRC and the PRA/PRC ratio were similar in four groups. After ve...

In 2013, the Organ Procurement and Transplantation Network in the United States approved a new national deceased donor kidney allocation policy that introduces the kidney donor profile index (KDPI), which gives scores of 0%-100% based on 10 donor factors. Kidneys with lower KDPI scores are associated with better post-transplant survival. Important features of the new policy include first alloca...

PCR-restriction fragment length polymorphism analysis (PRA) of the hsp65 gene (A. Telenti, F. Marchesi, M. Balz, F. Bally, E. C. Böttger, and T. Bodmer, J. Clin. Microbiol. 31:175-178, 1993) was applied to 108 mycobacterial isolates representing 34 species to evaluate its potential as a rapid reference method. A total of 49 distinct patterns were obtained; 25 species were characterized by a sin...

Hyperacute rejection is a rare but potentially catastrophic complication after cardiac transplantation. We describe an unusual case of hyperacute rejection due to preformed anti-donor antibodies despite a negative preoperative panel-reactive antibody (PRA) screen. An excellent outcome was achieved in this case and our strategy involving the use of CentriMag ventricular assist devices (VADs) for...

Thirty-eight sequentially placed liver and kidney allografts were evaluated with respect to patient and graft survival, and the influence of preformed lymphocytotoxic antibodies was analysed. The results suggest that the survival rate of combined liver and kidney transplantation is similar to the survival rate of liver transplantation alone. Sequentially placed kidney allografts may be protecte...