Increased access to transplantation of highly sensitized patients under the new kidney allocation system. A single center experience

Adriana I. Colovai, Maria Ajaimy, Layla G. Kamal, Peter Masiakos, Shirley Chan, Christina Savchik, Michelle Lubetzky, Graciela de Boccardo, Alesa Courson, Attasit Chokechanachaisakul, Jay A. Graham, Stuart M. Greenstein, Milan Kinkhabwala, Juan P. Rocca, Enver Akalin

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

We aimed to investigate the impact of the new kidney allocation system (KAS) on the rate of transplantation of sensitized patients at our center. Pre-KAS and post-KAS intervals were Jan 1st to Dec 3rd 2014 and Jan 1st 2015 to Dec 3rd 2015, respectively. The number of deceased-donor crossmatches performed by flow cytometry increased from 715 pre-KAS to 1188 post-KAS. The percent of crossmatches performed for sensitized patients with calculated panel reactive antibody (cPRA). >. 0% increased from 19% pre-KAS to 26% post-KAS (p. <. 0.0001). The number of deceased-donor kidney transplants performed at our center increased from 115 pre-KAS to 125 post-KAS (9% increase). There was a significant increase in the percentage of deceased-donor kidney transplants received by sensitized candidates (from 14% to 26% pre- and post-KAS, respectively; p. <. 0.0001). The highest increase was seen in the patients with cPRA. >. 98%, from 0% to 9%, followed by the group with cPRA 50-79%, from 5% to 8%. This increase was balanced by a decrease of 12% in the percentage of non-sensitized recipients, and a modest decrease of 1% in the group with cPRA 1-49%. In conclusion, transplant rate has increased in sensitized patients after KAS. The highest increase was observed among highly sensitized patients (cPRA. >. 98%).

Original languageEnglish (US)
JournalHuman Immunology
DOIs
StateAccepted/In press - Oct 20 2016

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Transplantation
Kidney
Antibodies
Flow Cytometry
Tissue Donors
Transplants

Keywords

  • HLA sensitization
  • Kidney allocation system
  • Kidney transplantation
  • Panel reactive antibody

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Increased access to transplantation of highly sensitized patients under the new kidney allocation system. A single center experience. / Colovai, Adriana I.; Ajaimy, Maria; Kamal, Layla G.; Masiakos, Peter; Chan, Shirley; Savchik, Christina; Lubetzky, Michelle; de Boccardo, Graciela; Courson, Alesa; Chokechanachaisakul, Attasit; Graham, Jay A.; Greenstein, Stuart M.; Kinkhabwala, Milan; Rocca, Juan P.; Akalin, Enver.

In: Human Immunology, 20.10.2016.

Research output: Contribution to journalArticle

Colovai, Adriana I. ; Ajaimy, Maria ; Kamal, Layla G. ; Masiakos, Peter ; Chan, Shirley ; Savchik, Christina ; Lubetzky, Michelle ; de Boccardo, Graciela ; Courson, Alesa ; Chokechanachaisakul, Attasit ; Graham, Jay A. ; Greenstein, Stuart M. ; Kinkhabwala, Milan ; Rocca, Juan P. ; Akalin, Enver. / Increased access to transplantation of highly sensitized patients under the new kidney allocation system. A single center experience. In: Human Immunology. 2016.
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abstract = "We aimed to investigate the impact of the new kidney allocation system (KAS) on the rate of transplantation of sensitized patients at our center. Pre-KAS and post-KAS intervals were Jan 1st to Dec 3rd 2014 and Jan 1st 2015 to Dec 3rd 2015, respectively. The number of deceased-donor crossmatches performed by flow cytometry increased from 715 pre-KAS to 1188 post-KAS. The percent of crossmatches performed for sensitized patients with calculated panel reactive antibody (cPRA). >. 0{\%} increased from 19{\%} pre-KAS to 26{\%} post-KAS (p. <. 0.0001). The number of deceased-donor kidney transplants performed at our center increased from 115 pre-KAS to 125 post-KAS (9{\%} increase). There was a significant increase in the percentage of deceased-donor kidney transplants received by sensitized candidates (from 14{\%} to 26{\%} pre- and post-KAS, respectively; p. <. 0.0001). The highest increase was seen in the patients with cPRA. >. 98{\%}, from 0{\%} to 9{\%}, followed by the group with cPRA 50-79{\%}, from 5{\%} to 8{\%}. This increase was balanced by a decrease of 12{\%} in the percentage of non-sensitized recipients, and a modest decrease of 1{\%} in the group with cPRA 1-49{\%}. In conclusion, transplant rate has increased in sensitized patients after KAS. The highest increase was observed among highly sensitized patients (cPRA. >. 98{\%}).",
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AU - Colovai, Adriana I.

AU - Ajaimy, Maria

AU - Kamal, Layla G.

AU - Masiakos, Peter

AU - Chan, Shirley

AU - Savchik, Christina

AU - Lubetzky, Michelle

AU - de Boccardo, Graciela

AU - Courson, Alesa

AU - Chokechanachaisakul, Attasit

AU - Graham, Jay A.

AU - Greenstein, Stuart M.

AU - Kinkhabwala, Milan

AU - Rocca, Juan P.

AU - Akalin, Enver

PY - 2016/10/20

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N2 - We aimed to investigate the impact of the new kidney allocation system (KAS) on the rate of transplantation of sensitized patients at our center. Pre-KAS and post-KAS intervals were Jan 1st to Dec 3rd 2014 and Jan 1st 2015 to Dec 3rd 2015, respectively. The number of deceased-donor crossmatches performed by flow cytometry increased from 715 pre-KAS to 1188 post-KAS. The percent of crossmatches performed for sensitized patients with calculated panel reactive antibody (cPRA). >. 0% increased from 19% pre-KAS to 26% post-KAS (p. <. 0.0001). The number of deceased-donor kidney transplants performed at our center increased from 115 pre-KAS to 125 post-KAS (9% increase). There was a significant increase in the percentage of deceased-donor kidney transplants received by sensitized candidates (from 14% to 26% pre- and post-KAS, respectively; p. <. 0.0001). The highest increase was seen in the patients with cPRA. >. 98%, from 0% to 9%, followed by the group with cPRA 50-79%, from 5% to 8%. This increase was balanced by a decrease of 12% in the percentage of non-sensitized recipients, and a modest decrease of 1% in the group with cPRA 1-49%. In conclusion, transplant rate has increased in sensitized patients after KAS. The highest increase was observed among highly sensitized patients (cPRA. >. 98%).

AB - We aimed to investigate the impact of the new kidney allocation system (KAS) on the rate of transplantation of sensitized patients at our center. Pre-KAS and post-KAS intervals were Jan 1st to Dec 3rd 2014 and Jan 1st 2015 to Dec 3rd 2015, respectively. The number of deceased-donor crossmatches performed by flow cytometry increased from 715 pre-KAS to 1188 post-KAS. The percent of crossmatches performed for sensitized patients with calculated panel reactive antibody (cPRA). >. 0% increased from 19% pre-KAS to 26% post-KAS (p. <. 0.0001). The number of deceased-donor kidney transplants performed at our center increased from 115 pre-KAS to 125 post-KAS (9% increase). There was a significant increase in the percentage of deceased-donor kidney transplants received by sensitized candidates (from 14% to 26% pre- and post-KAS, respectively; p. <. 0.0001). The highest increase was seen in the patients with cPRA. >. 98%, from 0% to 9%, followed by the group with cPRA 50-79%, from 5% to 8%. This increase was balanced by a decrease of 12% in the percentage of non-sensitized recipients, and a modest decrease of 1% in the group with cPRA 1-49%. In conclusion, transplant rate has increased in sensitized patients after KAS. The highest increase was observed among highly sensitized patients (cPRA. >. 98%).

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