*Purpose: Most studies of sensitization in transplant candidates have focused on kidney candidates, and unacceptable antigens (UAs) for non-kidney candidates are believed to be underreported. In this study we examine sensitization in lung candidates, the frequency of reporting, and sensitization’s effect on offer rates.

*Methods: We used OPTN data to analyze the number of offers received by adult lung-alone registrations ever waiting 1/1/10-6/30/20. Bypass offers and offers from match runs where no organ was placed were excluded. We used the UNOS CPRA API to determine calculated panel reactive antibody (CPRA) values for all registrations at every time point where UAs were entered.

*Results: Of 29,586 registrations, 5,607 (19.0%) had at least one UA in their most recent waiting list record. Among sensitized candidates, the CPRA distribution across all centers was similar to the distributions at centers reporting UAs for ≥ 15% of their candidates or ≥ 25% of candidates (Fig 1). As expected, offer rates declined steadily as CPRA increased, and registrations with a CPRA ≥ 90% had an offer rate an order of magnitude lower than registrations with a mild to moderate level of sensitization (Fig 2).

*Conclusions: The distribution of CPRA for sensitized lung registrations is remarkably similar for all registrations vs registrations at centers entering the most complete sensitization data. This suggests that the overall CPRA distribution reflects the true distribution of CPRA for sensitized candidates, despite potential underreporting of UAs. The offer rate also decreases as CPRA increases, indicating that sensitized candidates have reduced access to donor lungs. These data support the inclusion of CPRA as an attribute in a points-based, “continuous distribution” policy for lungs.

« Back to 2021 American Transplant Congress