Thursday, January 7, 2010

What's my PRA? 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 antibiodies 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 been 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.

Harvey Mysel is a kidney transplant recipient and Founder of the Living Kidney Donors Network, a nonprofit organization that offers Workshops and Get-Togethers to educate people in need of a kidney transplant about living kidney donation and helps prepare them to effectively communicate their need to family members and friends. The Living Kidney Donors Network website is: and Harvey could be reached at: or follow him on Twitter


  1. If you have a High PRA, know that the following transplant enter specialize in getting you transplanted:

    Mayo Brothers in MN
    Cedar Sinai in Los Angeles
    John Hopkins in NY

    Also, those centers known to also deal with High PRA patients are:

    UC Davis in CA
    Stanford University in CA

    Hope that helps!


    1. Thank you, Kelli, for the info! I just found out my PRA is 89. So far UCSF hasn't said they can't do the transplant. It is good to know about UC Davis and Cedar Sinai as possibilities! Thank you, again. God bless!