13-P

Abstract

Aim The use of the Virtual Crossmatch (VC) strategy, implemented in 2009, has resulted in fewer positive crossmatches and more accurate identification of anti-HLA specificities or Calculated Percent Reactive Antibody (CPRA) generated by HLA antigen bead arrays. As a result of VC there has been an increase in renal transplantation of sensitized recipients utilizing both Deceased Cadaver Donor (DCD) and living donor kidneys. Methods We examined this increase and other indices at our center. The table below shows the results of this analysis over time [ Table 1 ]. Results We have demonstrated an increase from six to eleven sensitized recipient’s transplants from 2007 until 2011. In addition there was an increase in the CPRA for these patients from 57% to 85%. The increase in transplants and an increase in CPRA demonstrate the diagnostic power of the new anti-HLA Ab detection techniques to define an individual’s sanitization profile and select a suitable donor. The rejection incidence (%) has decreased while the number of patient on the wait list has increased. The rejection episode decrease may be due to improved anti HLA identification pre and post transplant. This decrease may also be a result of new induction, maintenance, and anti-rejection therapies used with donor specific anti-HLA monitoring in the management of these patients. The cause of the decrease in DCD workups is still under study, but may be the result of a more efficient donor selection process (VC). Conclusions In conclusion: 1) The use of the virtual crossmatch increased the number of renal transplants in sensitized recipients with fewer donor workups; 2) The CPRA for this sensitized group has also increased. 3) The rejection rate has decreased in this “virtual crossmatch era”.