The new kidney allocation system does not equally advantage all very high cPRA candidates - A single center analysis

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• 作者：Amy B. Hahn^a ; ^{hahna@mail.amc.edu} ; Maryanne Mackey^a ; Don Constantino^a ; Ashar Ata^b ; Nikolaos Chandolias^c ; Reynold Lopez-Soler^c ; David J. Conti^c
• 关键词：cPRA ; calculated panel reactive antibody ; EPTS ; estimated post-transplant survival ; KAS ; kidney allocation system ; KDPI ; kidney donor profile index ; OPTN ; Organ Procurement and Transplant Network ; UAs ; unacceptable antigens ; UNOS ; United Network for Organ Sharing
• 刊名：Human Immunology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：78
• 期：1
• 页码：37-40
• 全文大小：580 K
• 卷排序：78

文摘

The new UNOS kidney allocation system awards very high points to candidates with cPRA 99% and 100%, and allows for national sharing for cPRA 100% candidates. We sought to determine the effect of this new kidney allocation system on candidates who are very highly sensitized (90–98% cPRA) but not eligible for very high points or national sharing by examining offers to these candidates for 5 months pre-implementation and two consecutive 5 month periods post-implementation and comparing them to cPRA ⩾ 99% candidates. We found that the cPRA ⩾ 99% candidates received significantly more offers and transplants after implementation, while offers and transplants to the 90–98% candidates decreased. A slight adjustment to the allocation system may be needed to provide more equitable distribution of kidneys to all high cPRA candidates.