Kidney paired donation (KPD) can facilitate living donor transplantation for candidates with an incompatible donor, but it is unclear how sensitization or blood type affects the success of matching.

METHODS: We retrospectively studied disposition of donor/candidate pairs who registered for the National Kidney Registry (NKR) 10/11-9/15 using a competing risk model.

RESULTS: Registrant candidates (N=1894) were 52.3% male, average age 49 years, 65.9% white, 59.4% ABO O, and 41.8% had PRA 80+ (Table). Overall, 50.5% registrants obtained KPD through NKR, 5.4% obtained KPD by other means, 7.3% found a compatible donor, 9.4% received a DDKT, 4.0% had their paired donor become unavailable, 4.8% died or were too sick to remain registered, 6.8% were removed for other reasons, and 11.9% continued to wait (Figure). Candidates with PRA 80-97 and 98+ were 23% [95% CI: 6.0-37%] and 83% [78-87%] less likely to be matched than PRA 0 candidates. ABO O candidates were 67% [60-72%] less likely to be matched versus ABO A. Candidates with ABO B or O donors were 25% [5-50%] more likely and 116% [81 -160%] more likely to match versus ABO A donors. Older candidates had increased chance of matching by 5% for each decade of age [0.2-10%].

CONCLUSIONS: Candidates who are highly sensitized or have blood type O may have longer waiting times for KPD.

Table. Demographics of Registrant Pairs

Figure. Time to Transplant in NKR.

CITATION INFORMATION: Holscher C, Chow E, Purcell C, Ronin M, Garonzik-Wang J, Massie A, Gentry S, Segev D. Sensitized KPD Pairs Take Longer to Find Matches. Am J Transplant. 2017;17 (suppl 3).

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