Early Impact of the New Kidney Allocation System (KAS) in Highly Sensitized Patients.
University of Alabama at Birmingham, Birmingham, AL.
Meeting: 2016 American Transplant Congress
Abstract number: C86
Keywords: Allocation, Kidney, Outcome, Sensitization
Session Information
Date: Monday, June 13, 2016
Session Name: Poster Session C: Economics, Public Policy, Allocation, Ethics
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Purpose
Highly sensitized (HS) patients, defined as a PRA of 99-100% are awarded additional priority points in the new KAS instituted December 2014. We evaluated the impact of these changes at our institution
Methods
HS candidates who received a transplant on or after 12/4/2014 were prospectively monitored. Treatment included induction with anti-thymocyte globulin & IV corticosteroids, maintenance with tacrolimus, mycophenolate & prednisone. Designated care providers followed the HS recipients with more intensive frequency, donor specific anti HLA antibody (DSA) & viral monitoring, implantation & 6 month surveillance biopsies. Outcomes of interest were rate of transplantation, patient & allograft survival and function, acute cellular or antibody mediated rejection (AbMR)
Results
There were 15 HS patients transplanted at our center between 12/5/14-10/5/15. The rate of transplant has risen from 1.6% in 2012 to 12.6% in 2015 
60% of these were from national offers in contrast to 37.5% prior to the new KAS
10 of these 15 recipients have >6 months follow up time, with 100% patient & graft survival
Allograft function 
No patients have experienced graft dysfunction due to acute cellular or AbMR. Surveillance monitoring found emergence of DSA in 1 patient at day 21, allograft biopsy had evidence of subclinical AbMR treated with plasmapheresis, IVIG & Rituximab (creatinine at last follow up: 0.9 mg/dl). A second recipient has a DSA to CW7 with a MFI 1100 at 3 months and no AbMR on 6 months surveillance biopsy
Conclusions
More national offers under the new KAS have resulted in more transplants for HS candidates, with excellent early patient and allograft survival and function. However these patients are resource intensive, requiring intense individualized monitoring and care. At our single center, the new KAS has benefited the HS candidates.
CITATION INFORMATION: Mompoint-Williams D, Gaston R, Jeremy G, Locke J, Kumar V. Early Impact of the New Kidney Allocation System (KAS) in Highly Sensitized Patients. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Mompoint-Williams D, Gaston R, Jeremy G, Locke J, Kumar V. Early Impact of the New Kidney Allocation System (KAS) in Highly Sensitized Patients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/early-impact-of-the-new-kidney-allocation-system-kas-in-highly-sensitized-patients/. Accessed March 3, 2021.« Back to 2016 American Transplant Congress