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Abstract
Incompatible live donor kidney transplantation (ILDKT) offers a survival advantage over dialysis to patients with anti-HLA donor-specific antibody (DSA). Program-specific reports (PSRs) fail to account for ILDKT, placing this practice at regulatory risk. We collected DSA data, categorized as positive Luminex, negative flow crossmatch (PLNF) (n?=?185), positive flow, negative cytotoxic crossmatch (PFNC) (n?=?536) or positive cytotoxic crossmatch (PCC) (n?=?304), from 22 centers. We tested associations between DSA, graft loss and mortality after adjusting for PSR model factors, using 9669 compatible patients as a comparison. PLNF patients had similar graft loss; however, PFNC (adjusted hazard ratio [aHR]?=?1.64, 95% confidence interval [CI]: 1.15-2.23, p?=?0.007) and PCC (aHR?=?5.01, 95% CI: 3.71-6.77, p?
View details for DOI 10.1111/ajt.12786
View details for Web of Science ID 000338024700017