Date: Sunday, May 3, 2015
Session Name: Concurrent Session: Pediatric Kidney Transplantation
Session Time: 4:00pm-5:30pm
Presentation Time: 4:24pm-4:36pm
Location: Room 119-A
Background. Most pediatric (ped) kidney (KI) recipients (recips) received 1- or 2-DR HLA mistmached (MM) deceased donor (DD) kidneys. The degree of HLA MM between donor and recip has been associated with the degree of anti-HLA sensitization after a graft loss. This analysis was conducted to examine sensitization level at retransplant (retx) among non-sensitized ped recips of first DD KI txs.
Data and Methods. OPTN data was analyzed for non-sensitized (PRA of 0%) ped (0-17) and adult (18+) recips of first non-0 ABDR MM DD KI alone txs during 1/1/90-12/31/10. PRA was used prior to 10/1/09 and calculated PRA (CPRA) on or after 10/1/09. Retx rate within 10 yrs was estimated using a competing risk method stratified by DR MM level. For recips who received a retx, sensitization level at retx was tabulated by HLA DR MM level at first tx and compared using a chi-square test.
Results. Among 3,882 non-sensitized (PRA of 0%), first non-0 ABDR MM DD KI recips, 318 (8%) received 0-DR, 1,844 (48%) received 1-DR, and 1,720 (44%) received 2-DR MM txs. Retx rate within 10 yrs was 20% for 0-DR, 21% for 1-DR, and 19% for 2-DR MM txs. Table 1 shows that among the 713 non-sensitized ped recips who subsequently received a retx as of the time of the analysis, the distribution of sensitization level at retx was not different by DR MM level at first tx (p=0.8). For example, the percent of peds who were highly sensitized (PRA 80%+) at retx was 31% for 0-DR, 39% for 1-DR, and 38% for 2-DR MM first txs. For adults, the distribution of sensitization level at retx was significantly different by DR MM level at first tx (p<0.01). For example, the percent of adults who became highly sensitized at retx was 22% for 0-DR, 31% for 1-DR, and 34% for 2-DR MM.
Conclusions. The majority of non-sensitized, first non-0 ABDR MM KI ped recips received 1- or 2-DR MM txs. Retx rates were similar among DR MM levels at about 20%. Among non-sensitized ped recips of first, non-0 ABDR MM txs, sensitization level at repeat tx did not seem to be associated with DR MM level at first tx.
To cite this abstract in AMA style:Cherikh W, Wilk A, McGehee H, Brewer E. Sensitization Level at Retransplant Among Non-Sensitized Pediatric Recipients of First Deceased Donor Kidney Transplants Not Affected by DR Mismatch Level [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/sensitization-level-at-retransplant-among-non-sensitized-pediatric-recipients-of-first-deceased-donor-kidney-transplants-not-affected-by-dr-mismatch-level/. Accessed September 20, 2019.
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