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Allocation to highly sensitized patients based on acceptable mismatches results in low rejection rates comparable to nonsensitized patients.
Heidt, Sebastiaan; Haasnoot, Geert W; Witvliet, Marian D; van der Linden-van Oevelen, Marissa J H; Kamburova, Elena G; Wisse, Bram W; Joosten, Irma; Allebes, Wil A; van der Meer, Arnold; Hilbrands, Luuk B; Baas, Marije C; Spierings, Eric; Hack, Cornelis E; van Reekum, Franka E; van Zuilen, Arjan D; Verhaar, Marianne C; Bots, Michiel L; Drop, Adriaan C A D; Plaisier, Loes; Seelen, Marc A J; Sanders, Jan-Stephan; Hepkema, Bouke G; Lambeck, Annechien J A; Bungener, Laura B; Roozendaal, Caroline; Tilanus, Marcel G J; Voorter, Christina E; Wieten, Lotte; van Duijnhoven, Elly M; Gelens, Marielle A C J; Christiaans, Maarten H L; van Ittersum, Frans J; Nurmohamed, Shaikh A; Lardy, Neubury M; Swelsen, Wendy; van der Pant, Karlijn A M I; van der Weerd, Neelke C; Ten Berge, Ineke J M; Bemelman, Frederike J; Hoitsma, Andries; van der Boog, Paul J M; de Fijter, Johan W; Betjes, Michiel G H; Otten, Henny G; Roelen, Dave L; Claas, Frans H J.
Afiliación
  • Heidt S; Eurotransplant Reference Laboratory, Leiden University Medical Center, Leiden, the Netherlands.
  • Haasnoot GW; Eurotransplant Reference Laboratory, Leiden University Medical Center, Leiden, the Netherlands.
  • Witvliet MD; Eurotransplant Reference Laboratory, Leiden University Medical Center, Leiden, the Netherlands.
  • van der Linden-van Oevelen MJH; Eurotransplant Reference Laboratory, Leiden University Medical Center, Leiden, the Netherlands.
  • Kamburova EG; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Wisse BW; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Joosten I; Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Laboratory Medicine, Laboratory of Medical Immunology, Nijmegen, the Netherlands.
  • Allebes WA; Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Laboratory Medicine, Laboratory of Medical Immunology, Nijmegen, the Netherlands.
  • van der Meer A; Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Laboratory Medicine, Laboratory of Medical Immunology, Nijmegen, the Netherlands.
  • Hilbrands LB; Radboud University Medical Center, Department of Nephrology, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.
  • Baas MC; Radboud University Medical Center, Department of Nephrology, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.
  • Spierings E; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Hack CE; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
  • van Reekum FE; Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
  • van Zuilen AD; Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Verhaar MC; Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Bots ML; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Drop ACAD; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Plaisier L; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Seelen MAJ; Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  • Sanders JS; Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  • Hepkema BG; Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  • Lambeck AJA; Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  • Bungener LB; Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  • Roozendaal C; Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  • Tilanus MGJ; Department of Transplantation Immunology, Tissue Typing Laboratory, Maastricht University Medical Centre, Maastricht, the Netherlands.
  • Voorter CE; Department of Transplantation Immunology, Tissue Typing Laboratory, Maastricht University Medical Centre, Maastricht, the Netherlands.
  • Wieten L; Department of Transplantation Immunology, Tissue Typing Laboratory, Maastricht University Medical Centre, Maastricht, the Netherlands.
  • van Duijnhoven EM; Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Centre, Maastricht, the Netherlands.
  • Gelens MACJ; Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Centre, Maastricht, the Netherlands.
  • Christiaans MHL; Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Centre, Maastricht, the Netherlands.
  • van Ittersum FJ; Department of Nephrology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
  • Nurmohamed SA; Department of Nephrology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
  • Lardy NM; Department of Immunogenetics, Sanquin Diagnostic Services, Amsterdam, the Netherlands.
  • Swelsen W; Department of Immunogenetics, Sanquin Diagnostic Services, Amsterdam, the Netherlands.
  • van der Pant KAMI; Department of Internal Medicine, Amsterdam University Medical Center, University of Amsterdam, Renal Transplant Unit, Amsterdam, the Netherlands.
  • van der Weerd NC; Department of Internal Medicine, Amsterdam University Medical Center, University of Amsterdam, Renal Transplant Unit, Amsterdam, the Netherlands.
  • Ten Berge IJM; Department of Internal Medicine, Amsterdam University Medical Center, University of Amsterdam, Renal Transplant Unit, Amsterdam, the Netherlands.
  • Bemelman FJ; Department of Internal Medicine, Amsterdam University Medical Center, University of Amsterdam, Renal Transplant Unit, Amsterdam, the Netherlands.
  • Hoitsma A; Dutch Organ Transplant Registry (NOTR), Dutch Transplant Foundation (NTS), Leiden, the Netherlands.
  • van der Boog PJM; Department of Nephrology, Leiden University Medical Center, Leiden, the Netherlands.
  • de Fijter JW; Department of Nephrology, Leiden University Medical Center, Leiden, the Netherlands.
  • Betjes MGH; Department of Nephrology, Erasmus Medical Center, Rotterdam, the Netherlands.
  • Otten HG; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Roelen DL; Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands.
  • Claas FHJ; Eurotransplant Reference Laboratory, Leiden University Medical Center, Leiden, the Netherlands.
Am J Transplant ; 19(10): 2926-2933, 2019 10.
Article en En | MEDLINE | ID: mdl-31155833
Whereas regular allocation avoids unacceptable mismatches on the donor organ, allocation to highly sensitized patients within the Eurotransplant Acceptable Mismatch (AM) program is based on the patient's HLA phenotype plus acceptable antigens. These are HLA antigens to which the patient never made antibodies, as determined by extensive laboratory testing. AM patients have superior long-term graft survival compared with highly sensitized patients in regular allocation. Here, we questioned whether the AM program also results in lower rejection rates. From the PROCARE cohort, consisting of all Dutch kidney transplants in 1995-2005, we selected deceased donor single transplants with a minimum of 1 HLA mismatch and determined the cumulative 6-month rejection incidence for patients in AM or regular allocation. Additionally, we determined the effect of minimal matching criteria of 1 HLA-B plus 1 HLA-DR, or 2 HLA-DR antigens on rejection incidence. AM patients showed significantly lower rejection rates than highly immunized patients in regular allocation, comparable to nonsensitized patients, independent of other risk factors for rejection. In contrast to highly sensitized patients in regular allocation, minimal matching criteria did not affect rejection rates in AM patients. Allocation based on acceptable antigens leads to relatively low-risk transplants for highly sensitized patients with rejection rates similar to those of nonimmunized individuals.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Donantes de Tejidos / Trasplante de Riñón / Inmunización / Selección de Paciente / Rechazo de Injerto / Histocompatibilidad / Antígenos HLA / Fallo Renal Crónico Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2019 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Donantes de Tejidos / Trasplante de Riñón / Inmunización / Selección de Paciente / Rechazo de Injerto / Histocompatibilidad / Antígenos HLA / Fallo Renal Crónico Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2019 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos