Quantifying the Risk of Incompatible Kidney Transplantation: A Multicenter Study AMERICAN JOURNAL OF TRANSPLANTATION Orandi, B. J., Garonzik-Wang, J. M., Massie, A. B., Zachary, A. A., Montgomery, J. R., Van Arendonk, K. J., Stegall, M. D., Jordan, S. C., Oberholzer, J., Dunn, T. B., Ratner, L. E., Kapur, S., Pelletier, R. P., Roberts, J. P., Melcher, M. L., Singh, P., Sudan, D. L., Posner, M. P., El-Amm, J. M., Shapiro, R., Cooper, M., Lipkowitz, G. S., Rees, M. A., Marsh, C. L., Sankari, B. R., Gerber, D. A., Nelson, P. W., Wellen, J., Bozorgzadeh, A., Gaber, A. O., Montgomery, R. A., Segev, D. L. 2014; 14 (7): 1573-1580

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