Test Results Panel Reactive Antibody (cPRA)

*Timeline requirements for this form are as follows:
Assessment timeframe: Pre-Transplant
Submission timeframe:

Date of cPRA test draw __________
Enter the date the blood specimen was collected and used to obtain the Calculated Reactive Antibodies (cPRA) percentage. Enter the date in the DD/MMM/YYYY.

Is test draw date within 3 months prior to enrollment?
Indicate if the test draw was within 3 months prior to enrollment into the study

• Yes
• No
  

cPRA test result _______ %
Enter the result of the cPRA test in the “NNN” format. This format allows up to three digits without a decimal.

CCG v.1 | CRF v.1

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CIBMTR® (Center for International Blood and Marrow Transplant Research) is a research collaboration between the Medical College of Wisconsin and NMDP.