Background: Sensitized patients have had prolonged waiting times and greater incidence of death while on the waiting list. On December 4, 2014, UNOS/OPTN activated a new KAS for deceased donor (DD) kidneys that gives priority at the regional level to candidates with calculated panel reactive antibody (CPRA) value =99% and at the national level to patients with CPRA =100%. Transplants performed at our center under the new KAS were reviewed to assess early outcomes.

Methods: Single center, retrospective data review of patients with CPRA values >98% transplanted between December 4, 2014 and November 15, 2015.

Results: We performed 151 DD kidney transplants since the new KAS. 51 prospective, cell-based flow cytometry crossmatches were performed on patients with CPRA >98%; 33 were compatible and 22 patients were transplanted. Patient characteristics are detailed in Table 1. 95% of patients have functioning grafts at median follow-up of 159 days. 5 patients had weak pre-formed DSA to HLA class I antigens. One patient developed de novo DSA to an HLA class II specificity. None of the patients had clinical rejection episodes. One patient had prolonged delayed graft function. Compatible matches that were not transplanted were mostly due to kidney being allocated to a patient higher in the sequence.

Conclusion: Since the new KAS, highly sensitized patients received 14.5% of the DD Kidney transplants at our center, compared to 11.5% in the UNOS registry data. Transplanted patients have excellent short term outcomes without early clinical rejection episodes. Long-term follow-up is needed to better evaluate the impacts of this new KAS.

CITATION INFORMATION: Kaur N, Goral S, Kearns J, Abt P, Naji A, Porrett P, Levine M, Kamoun M. Kidney Transplant Outcomes in Patients with CPRA Values >98% After Implementation of the New OPTN/UNOS Kidney Allocation System (KAS): A Single Center Study Update. Am J Transplant. 2016;16 (suppl 3).

« Back to 2016 American Transplant Congress