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Authors Parajuli S, Redfield RR, Astor BC, Djamali A, Kaufman D, Mandelbrot DA
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Journal Clin Transplant
Publish Date 2016 Dec 17
PubMed ID 27988992
Abstract

Since the institution of the new kidney allocation system in December 2014, kidney transplant candidates with the highest calculated panel reactive antibodies (cPRA) of 99-100 have been transplanted at much higher rates. However, concerns have been raised that outcomes in these patients might be impaired due to higher immunological risk and longer cold ischemia times resulting from long-distance sharing of kidneys. Here we compare outcomes at the University of Wisconsin between study patients with cPRA 99-100 and all other recipients of deceased donor kidneys transplanted between 12/04/2014 and12/31/2015. All patients had at least six months post-transplant follow up. The mean follow up was 13.9±3 months in cPRA ≥ 99% and 12.3±3.5 months in cPRA ≤98%. There were a total of 152 transplants, 25 study patients and 127 controls. No statistically significant differences were found between the two groups in delayed graft function, rejection, kidney function, graft and patient survival or infections. We conclude that transplanting the most highly sensitized patients with kidneys shared outside their local donation service areas is associated with excellent short-term outcomes that are comparable to controls. This article is protected by copyright. All rights reserved.

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