Sensitization Status of Patients on the Deceased Donor Kidney Transplant Waiting List: A Single-Center Experience

Abstract

Objectives: This study aimed to analyze the features of patients on the deceased donor kidney transplant waiting list and risk factors associated with sensitization that affect panel reactive antibody status in our center.

Methods: Patients' data were collected retrospectively. Panel reactive antibody screening and definition tests were studied for class I (A, B, and C) and class II (DR, DP, DQ) antigens with Luminex every 6 months. Patients with panel reactive antibody >5% and antibody strength >1000 median fluorescence intensity were considered panel reactive antibody-positive. Based on the panel reactive antibody status, the patients were divided into 2 groups: the panel reactive antibody-positive group and -negative group.

Results: A total of 338 patients (60% male, mean age: 52.6 +/- 14.6 years) were included in the analysis. Panel reactive antibody positivity was detected in 117 (34.6) patients on the waiting list. Compared with the panel reactive antibody-negative patient group, the panel reactive antibody-positive patient group had higher rate of women and lower age (P <.001 and P <.001, respectively). The patients in the panel reactive antibody-positive group also had longer dialysis vintage (P =.027), higher rate of blood transfusion history (P <.001), organ transplant (P <.001), and higher number of blood transfusion (P <.001). Female gender (odd ratio:4.094, 95% CI:2.275-7.368, P <.001), history of blood transfusion (odds ratio:2.027, 95% CI:1.131-3.633, P =.018), and organ transplant (odds ratio:16.894, 95% CI:7.212-39.578, P <.001) were independent risk factors associated with panel reactive antibody positivity.

Conclusion: Updates of the organ allocation system to consider sensitized patients and new strategies to expand the donor pool and donation rates are needed in Turkiye.