Kidney transplant outcomes in patients with CPRA values [formula omitted] 99% after the implementation of the new OPTN/UNOS kidney allocation system (KAS) – A single center study

Abstract

Aim Sensitized patients have prolonged wait times and a greater incidence of death while on the waiting list. On December 4, 2014, OPTN/UNOS activated a new KAS for deceased donors (DD) that gives priority at the regional level to candidates with calculated panel reactive antibody (CPRA) value = 99% and at the national level to patients with CPRA = 100%. Transplants performed at our center under the new KAS were reviewed to assess early outcomes. Methods Single center, retrospective data review of patients with CPRA values > 98% transplanted between December 4, 2014 and April 30, 2015. Results We performed 51 DD kidney transplants since the new KAS. 24 crossmatches were performed on patients with CPRA > 98%, 13 crossmatches were reported as compatible and 8 patients were transplanted. Characteristics of the patient cohort are detailed in Table 1. Majority of the patients were multiparous women and had history of blood transfusions. Seven patients (87.5%) have functioning grafts at median follow up of 94 (52,128) days. One patient had primary non-function. One patient developed a weak anti-HLA class I DSA that resolved subsequently. None of the patients had rejection episodes. Conclusion At our center, since the new KAS was implemented, 8 highly sensitized patients were quickly transplanted with excellent short term outcomes and without early rejection episodes. Long-term follow-up is needed to understand the consequences of this new KAS. Download : Download full-size image