Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
Background: On the waitlist, highly sensitized kidney (KI) candidates who undergo desensitization (DS) lose allocation priority associated with pre-DS CPRA value if some unacceptable antigens are removed. This can significantly lower a candidate's priority for KI offers.
Data and Methods: Between 6/4/15-9/4/15, the OPTN DS Workgroup of the Histocompatibility, Minority Affairs, and Kidney Transplantation Committees conducted a survey of KI programs and associated HLA labs. Overall response rate was 45%; 34% for Tx programs and 65% for labs. 45% of responses were from medical directors, 51% from lab directors, and 4% from others.
Results: 85% of respondents indicated that patients undergoing DS should be allowed to keep their pre-DS allocation points (DS exception-DS-Ex) with similar responses by medical and lab directors (Fig 1). 55% of respondent's centers currently perform DS and they were more likely to support DS-Ex (91% vs. 71%)
Among those supporting DS-Ex, 3/4 favored requiring a pre-DS minimum time period for presence of high CPRA for patients to qualify for DS-Ex. 83% respondents thought patients should keep DS-Ex for 6 months (16%), 1 year (20%) or until Tx'd (47%); the remaining 17% favored granting it for the entire DS duration plus some time afterwards or for other period of time. 75% (41%, 34%) of respondents indicated that a sustained pre-DS CPRA of ≥75% or ≥98% would be the appropriate threshold for DS-Ex. Lab directors were more likely to select a higher min value (Fig 2). 69% responded that all DS protocols should be considered equally.
Conclusions: The majority of respondents supported allowing patients undergoing DS to keep their pre-DS CPRA allocation priority with certain provisions. Changes to OPTN policy to allow for the DS-Ex may be warranted.
CITATION INFORMATION: Kucheryavaya A, Bray R, Tyan D. Survey Results Show Strong Support for Allowing Patients Undergoing Desensitization to Keep Their Pre-Desensitization CPRA Allocation Priority. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Kucheryavaya A, Bray R, Tyan D. Survey Results Show Strong Support for Allowing Patients Undergoing Desensitization to Keep Their Pre-Desensitization CPRA Allocation Priority. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/survey-results-show-strong-support-for-allowing-patients-undergoing-desensitization-to-keep-their-pre-desensitization-cpra-allocation-priority/. Accessed March 4, 2021.
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