P010 Higher definition CPRA: What’s the (decimal) point?

Autor: Patricia Campbell, Kathryn Tinckam, Robert S. Liwski, Mike Gillissie, Sean Delaney, Machi Danha, Marc Mousseau, Kyle Maru, Nick Lahaie
Rok vydání: 2017
Předmět:
Zdroj: Human Immunology. 78:61-62
ISSN: 0198-8859
DOI: 10.1016/j.humimm.2017.06.070
Popis: Aim cPRA is an estimate of the percentage of donors excluded by a potential recipient’s unacceptable antigens and is typically expressed as an integer. For very highly sensitized patients, integer rounding may reduce how informative cPRA is for important metrics such as time to DSA negative offer. We analyzed the distribution and clinical impact of cPRA to decimal point based (cPRAd) in a highly sensitized Canadian kidney waitlist (cPRA>=95%). Methods All patients registered the Canadian Blood Services’ Highly Sensitized Patient (HSP) Program included in at least one allocation run ( n = 1025) from 10/18/13 to 08/04/16 were included and cPRAd calculated to 1 decimal place. Distribution of cPRAd, time to first DSA negative match or to end of study period and proportion of patients transplanted by cPRAd was determined. Result 52% of subjects had cPRAd>=99.8%. 515 patients received at least one DSA negative match during the study period (Fig. 1A). Time to match increased progressively across cPRAd, notable even between integer values (Fig. 1B). Median time to first match increases progressively above cPRAd 98% and particularly above 99.7%. (Fig. 1C). Noting not all matches results in offers/transplants, for those patients transplanted with cPRAd>=98%, proportion transplanted decreases across cPRAd 0.1% intervals (Fig. 2) (Linear relationship = −0.279 * (cPRAd) + 27.95, R 2 = 0.59, p = 0.00004). Conclusions cPRAd provides more informative time to match and likelihood of transplant, than rounded integer cPRA, which in turn may better inform patients, and augment application in allocation strategies. Download high-res image (458KB) Download full-size image
Databáze: OpenAIRE
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