Question 1

What is the Meaning of CPRA?

Accepted Answer

CPRA, or Calculated Panel Reactive Antibody, represents a calculated percentage reflecting the likelihood that a transplant candidate will react positively to a randomly selected donor from the general population, based on the patient's existing antibodies against human leukocyte antigens (HLAs). This metric is derived from the patient's unacceptable antigens, which are specific HLA antibodies identified through laboratory testing.

Question 2

What is the Context of CPRA?

Accepted Answer

Within the field of solid organ transplantation, CPRA functions as a crucial immunological assessment tool. It operates within the intricate workings of the immune system and its recognition of foreign tissues, directly influencing the allocation of organs by providing an objective measure of a recipient's sensitization status.

Question 3

What is the Significance of CPRA?

Accepted Answer

CPRA holds significant clinical importance by quantifying the immunological barrier a patient faces in receiving a compatible organ. A higher CPRA indicates greater sensitization, predicting longer wait times for a suitable donor organ and an increased risk of hyperacute or acute rejection post-transplant, thus guiding pre-transplant risk stratification and donor matching strategies.

Question 4

What is the Mechanism of CPRA?

Accepted Answer

The calculation of CPRA relies on identifying a patient's specific anti-HLA antibodies, which are proteins produced by the immune system in response to prior exposure to foreign HLAs, often from transfusions, pregnancies, or previous transplants. These antibodies, if present, can target donor tissues, leading to immune-mediated damage; CPRA statistically models the probability of encountering a donor with those specific target antigens.

Question 5

What is the Application of CPRA?

Accepted Answer

Clinically, CPRA is routinely utilized in transplant centers worldwide to prioritize highly sensitized patients on organ waitlists, ensuring equitable access to organs for those facing substantial immunological challenges. It informs desensitization protocols aimed at reducing antibody levels and guides the selection of crossmatch-negative donors to minimize rejection risk.

Question 6

What is the Metric of CPRA?

Accepted Answer

CPRA is expressed as a percentage, typically ranging from 0% to 100%, and is calculated using a formula that considers the frequency of specific HLA antigens in the donor population and the patient's identified unacceptable antigens. This value is regularly updated as a patient's antibody profile changes, reflecting their current immunological status.

Question 7

What is the Risk of CPRA?

Accepted Answer

Patients with a very high CPRA face an elevated risk of transplant complications, including prolonged wait times leading to clinical deterioration, increased susceptibility to infections while awaiting a transplant, and a higher probability of graft failure due to antibody-mediated rejection if a compatible organ is not meticulously matched. Misinterpretation or inadequate management of high CPRA can lead to suboptimal patient outcomes.

CPRA

Meaning

Context

Significance

Mechanism

Application

Metric

Risk

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