Scandiatransplant acceptable mismatch program-10 years with an effective strategy for transplanting highly sensitized patients
| Autor: | Ilse Weinreich, Mats Bengtsson, Jouni Lauronen, Christian Naper, Kaie Lokk, Ilkka Helanterä, Margrét Birna Andrésdóttir, Søren Schwartz Sørensen, Lars Wennberg, Anna Varberg Reisæter, Bjarne Møller, Pernille Koefoed-Nielsen |
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| Přispěvatelé: | HUS Abdominal Center, IV kirurgian klinikka |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
organ allocation
kidney (allograft) function graft survival nephrology kidney transplantation organ procurement and allocation kidney transplantation/nephrology kidney (allograft) function/dysfunction clinical research/practice HLA Antigens panel reactive antibody (PRA) Urologi och njurmedicin alloantibody Immunology and Allergy Humans Urology and Nephrology Pharmacology (medical) histocompatibility Transplantation dysfunction Histocompatibility Testing Kirurgi health services and outcomes research 3126 Surgery anesthesiology intensive care radiology Kidney Transplantation Tissue Donors practice clinical research Surgery |
| Zdroj: | Weinreich, I, Bengtsson, M, Lauronen, J, Naper, C, Lokk, K, Helanterä, I, Andrésdóttir, M B, Sørensen, S S, Wennberg, L, Reisaeter, 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 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 |
| DOI: | 10.1111/ajt.17182 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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