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

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dc.contributor Landspitali - The National University Hospital of Iceland
dc.contributor.author Weinreich, Ilse
dc.contributor.author Bengtsson, Mats
dc.contributor.author Lauronen, Jouni
dc.contributor.author Naper, Christian
dc.contributor.author Lokk, Kaie
dc.contributor.author Helanterä, Ilkka
dc.contributor.author Andrésdóttir, Margrét Birna
dc.contributor.author Sørensen, Søren Schwartz
dc.contributor.author Wennberg, Lars
dc.contributor.author Reisæter, Anna Varberg
dc.contributor.author Møller, Bjarne
dc.contributor.author Koefoed-Nielsen, Pernille
dc.date.accessioned 2022-09-27T01:02:36Z
dc.date.available 2022-09-27T01:02:36Z
dc.date.issued 2022-12
dc.identifier.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 , vol. 22 , no. 12 , pp. 2869-2879 . https://doi.org/10.1111/ajt.17182
dc.identifier.issn 1600-6135
dc.identifier.other PURE: 60188815
dc.identifier.other PURE UUID: f5de920b-313a-442c-9fda-4031e5f17720
dc.identifier.other Scopus: 85137824292
dc.identifier.other unpaywall: 10.1111/ajt.17182
dc.identifier.other WOS: 000852760800001
dc.identifier.uri https://hdl.handle.net/20.500.11815/3483
dc.description Funding Information: Anders Åsberg has contributed to this paper by doing part of the graft survival statistical analysis. This work would not have been possible without the dedicated work by all the transplant professionals at each transplanted center. Furthermore, we are grateful for the dedicated help in the collection of rejection data. On behalf of the Nordic Kidney group and the Tissue Typing group in Scandiatransplant. Publisher Copyright: © 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.
dc.description.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.
dc.format.extent 11
dc.format.extent 2869-2879
dc.language.iso en
dc.relation.ispartofseries American Journal of Transplantation; 22(12)
dc.rights info:eu-repo/semantics/openAccess
dc.subject Nýrnalæknisfræði
dc.subject alloantibody
dc.subject clinical research/practice
dc.subject graft survival
dc.subject health services and outcomes research
dc.subject histocompatibility
dc.subject kidney (allograft) function/dysfunction
dc.subject kidney transplantation/nephrology
dc.subject organ allocation
dc.subject organ procurement and allocation
dc.subject panel reactive antibody (PRA)
dc.subject practice
dc.subject kidney transplantation
dc.subject dysfunction
dc.subject nephrology
dc.subject clinical research
dc.subject kidney (allograft) function
dc.subject Histocompatibility Testing
dc.subject Humans
dc.subject Graft Survival
dc.subject Kidney Transplantation
dc.subject HLA Antigens
dc.subject Tissue Donors
dc.subject Transplantation
dc.subject Pharmacology (medical)
dc.subject Immunology and Allergy
dc.title Scandiatransplant acceptable mismatch program—10 years with an effective strategy for transplanting highly sensitized patients
dc.type /dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article
dc.description.version Peer reviewed
dc.identifier.pmid 36030513
dc.identifier.doi https://doi.org/10.1111/ajt.17182
dc.relation.url http://www.scopus.com/inward/record.url?scp=85137824292&partnerID=8YFLogxK
dc.contributor.department Internal Medicine and Emergency Services

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