TY - JOUR
T1 - Increased access to transplantation of highly sensitized patients under the new kidney allocation system. A single center experience
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
Y1 - 2016/10/20
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%).
KW - HLA sensitization
KW - Kidney allocation system
KW - Kidney transplantation
KW - Panel reactive antibody
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U2 - 10.1016/j.humimm.2016.12.003
DO - 10.1016/j.humimm.2016.12.003
M3 - Article
C2 - 27955974
AN - SCOPUS:85009829344
JO - Human Immunology
JF - Human Immunology
SN - 0198-8859
ER -