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28 June 2019 : Original article  

Effect of Calculated Panel Reactive Antibody Value on Waitlist Outcomes for Lung Transplant Candidates

Meghan Aversa1ABCDEF*, Luke Benvenuto1ABCDEF, Hanyoung Kim2E, Lori Shah1E, Hilary Robbins1E, B. Payne Stanifer3E, Frank D’Ovidio3E, Elena-Rodica R. Vasilescu4E, Joshua Sonett3E, Selim M. Arcasoy1ACDE

DOI: 10.12659/AOT.915769

Ann Transplant 2019; 24:383-392

Abstract

BACKGROUND: We conducted a retrospective cohort study using United Network of Organ Sharing (UNOS) data to determine the effect of the calculated panel reactive antibody (cPRA) value on waitlist outcomes for lung transplant candidates.

MATERIAL AND METHODS: We divided lung transplant candidates into groups based on their cPRA value at the time of waitlist activation (0–25%, 25.1–50%, 50.1–75%, and 75.1–100%) and compared each group’s waitlist outcomes to the lowest quartile (“minimally sensitized”) group. The primary outcome was lung transplantation and the secondary outcome was waitlist mortality (a composite of death on the waitlist/delisting for clinical deterioration).

RESULTS: Compared to the minimally sensitized group, candidates with a cPRA value of 25.1–50% did not have a significantly different likelihood of undergoing lung transplant or waitlist mortality, candidates with a cPRA value of 50.1–75% were 25% less likely to undergo lung transplant and 44% more likely to die on the waitlist, and candidates with a cPRA value of 75.1–100% were 52% less likely to undergo lung transplant and 92% more likely to die on the waitlist.

CONCLUSIONS: CPRA values of greater than 50% are associated with significantly lower rates of transplantation and higher waitlist mortality.

Keywords: Antibodies, Lung Transplantation, Waiting Lists, HLA Antigens, Histocompatibility Testing, Middle Aged, Retrospective Studies, Survival Rate

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358