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Scandiatransplant acceptable mismatch program—10 years with an effective strategy for transplanting highly sensitized patients

Scandiatransplant acceptable mismatch program—10 years with an effective strategy for transplanting highly sensitized patients


Title: Scandiatransplant acceptable mismatch program—10 years with an effective strategy for transplanting highly sensitized patients
Author: Weinreich, Ilse
Bengtsson, Mats
Lauronen, Jouni
Naper, Christian
Lokk, Kaie
Helanterä, Ilkka
Andrésdóttir, Margrét Birna
Sørensen, Søren Schwartz
Wennberg, Lars
Reisæter, Anna Varberg
... 2 more authors Show all authors
Date: 2022-09-12
Language: English
Scope:
University/Institute: Landspitali - The National University Hospital of Iceland
Department: Internal Medicine and Emergency Services
Series: American Journal of Transplantation; ()
ISSN: 1600-6135
DOI: https://doi.org/10.1111/ajt.17182
Subject: Nýrnalæknisfræði; alloantibody; clinical research/practice; graft survival; health services and outcomes research; histocompatibility; kidney (allograft) function/dysfunction; kidney transplantation/nephrology; organ allocation; organ procurement and allocation; panel reactive antibody (PRA); practice; kidney transplantation; dysfunction; nephrology; clinical research; kidney (allograft) function; Transplantation; Pharmacology (medical); Immunology and Allergy
URI: https://hdl.handle.net/20.500.11815/3483

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Citation:

Weinreich , I , Bengtsson , M , Lauronen , J , Naper , C , Lokk , K , Helanterä , I , Andrésdóttir , M B , Sørensen , S S , Wennberg , L , Reisæter , A V , Møller , B & Koefoed-Nielsen , P 2022 , ' Scandiatransplant acceptable mismatch program—10 years with an effective strategy for transplanting highly sensitized patients ' , American Journal of Transplantation . https://doi.org/10.1111/ajt.17182

Abstract:

In March 2009, the Scandiatransplant acceptable mismatch program (STAMP) was introduced as a strategy toward improving kidney allocation to highly sensitized patients. Patients with a transplantability score ≤ 2% are potential candidates for the program. Samples are analyzed and acceptable antigens (HLA-A, B, C, DRB1, DRB3/4/5, DQB1, DQA1, DPB1, DPA1) are defined by the local tissue typing laboratory and finally evaluated by a steering committee. In the matching algorithm, patients have the highest priority when the donor's antigens are all among the recipient's own or acceptable HLA antigens. In the period from 2009 to 2020, we have transplanted 278 highly sensitized kidney patients through the program. The graft survival of the STAMP patients was compared with 9002 deceased donor kidney-transplanted patients, transplanted in the same time period. The 10-year graft survival was 73.4% (95% CI: 60.3–90.0) for STAMP and 82.9% (95% CI: 81.6–84.3) for the reference group. (p =.2). In conclusion, the 10-year allograft survival demonstrates that the STAMP allocation algorithm is immunological safe. The program is continuously monitored and evaluated, and the introduction of matching for all HLA loci is a huge improvement to the program and demonstrate technical adaptability as well as clinical flexibility in a de-centralized organization.

Description:

© 2022 The Authors. American Journal of Transplantation published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons.

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