中文摘要：

目的建立一种分析应用群体反应性抗体（PRA）阳性患者与供者不相容几率的校正PRA（cPRA）方法，采用校iFPRA（cPRA）方法分析临床肾侈植中受者获得移植物的几率。方法计算2000年1月～2012年12月间2004例移值供者HLA-A、B、DR基因以及A-B、A-DR、B-DR和A-B-DR单倍型出现的频率作为HLA数据库，对202例PRA阳性患者的CPRA进行分析，并评价PRA和CPRA的-致性。结果本研究基于2004例移植供者的HLA设计的CPRA－Java计算软件，从中输入PRA阳性受者的HLA特异性抗体，即可获得-个CPRA的百分数，代表受者不可接受的HLA基因在供者群体中存在的几率。202例PRA阳性受者平均强度为（23．12±17．83）％，CPRA均值为（46．07±23．30）％。低度致敏组（PRA〉0～10％）的平均强度（6．874±2．41）％与组中CPRA均值（21．634±11．75）％之间存在显著的统计学差异（P〈0．05）；中度致敏组（PRA〉10～30％）的平均强度为（20．154±5．70）％与组中CPRA均值（50．56±16．86）％之间存在显著的统计学差异（P〈0．05）；高度致敏组（PRA〉30％）中两值无显著的统计学差异（P〉0．05）。低度、中度致敏组中PRA强度与CPRA值的一致率为19．35％和10．99％（P〈0．05），高度致敏中PRA强度与CPRA值的一致率为100％（P〉0．05）。结论研究证明，PRA呈低度致敏时受者实际获得移植的几率可能比PRA强度反映的低；而PRA〉30％时CPRA均〉30％，证实PRA〉30％为肾移植的高危因素。研究表明，PRA反映了肾移植受者自身的致敏程度，可靠的HLA抗体特异性检测极为重要，而cPRA则可以如实反映受者获得移植的几率，为临床医师预测受者等待时间、选择移植方式提供依据。

英文摘要：

Objective To establish a calculated panel reactive antibody （CPRA） method to analyze the donor-recipient incompatibility rate in PRA-positive kidney recipients and estimate the probability of these recipients to receive kidney transplantation. Methods Based on the database of HLA-A,-B,-DR genes and A-B, A-DR, B-DR, A-B-DR haplotype frequencies collected from 2004 donors from Jan 2000 to Dec 2012, we analyzed CPRA in 202 PRA-posifive recipients and evaluated the consistency between PRA and CPRA assessments using a CPRA-Java calculator software, which returned a percentage of CPRA （representing the probability of unacceptable HLA in the donor group） after input of HLA-specific antibodies of a PRA-positive recipient. Result The mean PRA intensity of the 202 PRA-positive recipients was （23.12±17.83）% with a mean CPRA% of （46.07±23.30）%. A significant difference was found between the mean PRA% and CPRA% in low sensitized recipients （PRA 0-10% ） [（6.87 ± 2.41）% vs （21.63 ± 11.75）%, P〈0.05） and in moderately sensitized recipients （PRA 10%-30%） [（20.15_＋5.70）% vs （50.56±16.86）%, P〈0.05）, but not in highly sensitized recipients （PRA〉 30%）; The concordance rates between PRA% and CPRA% in the 3 groups were 19.35% （P〈0.05）, 10.99% （P〈0.05）, and 100% （P〉0.05）, respectively. Conclusions Lowly sensitized kidney recipients might have a lower probability of actually receiving a transplant than PRA% shows. A PRA% 〉30% is a risk factor for kidney transplantation. PRA reflects the sensitized level of a renal recipient, and reliable detection of HLA antibody specificity is of critical importance. CPRA accurately reflects the probability of a recipient to receive a transplant to assist clinicians in predicting the waiting time and selecting the transplant approach.