Kidney Allocation Based on CREGS Mismatches vs DR Matching Results in Improved Transplant Opportunities to Sensitized Patients; Review of SEOPF Data Base

Abstract

688 In the review of our Center's kidney data base, we previously reported that improved graft survival at 1 and 3 years correlated better for 0-2 Cross Reactive Groups (CREGS) mismatch (mm) than for 0 DR mm in highly sensitized (Peak PRA > 20%) patients. To challenge this finding in a larger patient population, we reviewed the SEOPF data base of sensitized patients. From October 1987 through July 1998, 3,853 patients with peak PRA > 20% received cadaver kidney transplants (excluding UNOS zero mismatch). CREGS were assigned according to the matching algorithm of Thompson and Thacker. When 0-2 CREGS mm was separated from 3-4 CREGS mm, these two groups were compared to DR matching. 0-2 CREGS mm kidneys had significantly better 1 and 3 year graft survival (GS) than 3-4 CREGS mm. This effect held for all levels of DR mm. (Table)Table0 DR mm independent of CREGS mm had a similar 1 and 3 year GS compared to 0-2 CREGS mm independent of DR mm. (Table)Table0-2 CREGS mm accounted for 3 times as many compatible kidneys transplanted into sensitized patients compared to 0 DR mm. Organ allocation based on CREGS mm may result in substantially more successful transplants when compared to DR matching.