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calculated panel reactive antibodies

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https://www.readbyqxmd.com/read/28164503/association-of-hla-types-with-non-specific-binding-of-negative-control-beads-in-luminex-panel-reactive-antibody-pra-screening-assay
#1
Nuri Lee, Hee Sue Park, Ji Won In, Eun Youn Roh, Sue Shin, Kyoung Un Park, Eun Young Song
BACKGROUND: Luminex panel reactive antibody (PRA) screening assays using microbeads are widely used for organ transplantation. Anti-HLA serum reactivity is calculated by correcting for non-specific binding to the negative control (NC) beads. High mean fluorescence intensity (MFI) value of NC beads are observed in some patients and can result in false negative results in the PRA screening assay. We analyzed the clinical characteristics and HLA types of those patients with high MFI values of NC beads...
January 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28162932/multicenter-evaluation-of-a-national-organ-sharing-policy-for-highly-sensitized-patients-listed-for-heart-transplantation-in-canada
#2
Brian Clarke, Anique Ducharme, Nadia Giannetti, Daniel Kim, Michael McDonald, Peter Pflugfelder, Miroslaw Rajda, Mario Sénéchal, Ellie Stadnick, Mustafa Toma, Shelley Zieroth, Debra Isaac
BACKGROUND: Transplantation of sensitized recipients has been associated with increased risk of post-transplant complications. In 2010, the Canadian Cardiac Transplant Network (CCTN) created a unique status listing for highly sensitized heart transplant candidates. Status 4S listing requires calculated panel-reactive antibody (cPRA) level >80% as the sole listing criteria and enables geographic expansion of the donor pool by providing national access. In this study, we describe patient characteristics and outcomes of those transplanted as Status 4S in Canada...
January 6, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28086979/b-cell-repertoires-in-hla-sensitized-kidney-transplant-candidates-undergoing-desensitization-therapy
#3
John F Beausang, H Christina Fan, Rene Sit, Maria U Hutchins, Kshama Jirage, Rachael Curtis, Edward Hutchins, Stephen R Quake, Julie M Yabu
BACKGROUND: Kidney transplantation is the most effective treatment for end-stage renal disease. Sensitization refers to pre-existing antibodies against human leukocyte antigen (HLA) protein and remains a major barrier to successful transplantation. Despite implementation of desensitization strategies, many candidates fail to respond. Our objective was to determine whether measuring B cell repertoires could differentiate candidates that respond to desensitization therapy. METHODS: We developed an assay based on high-throughput DNA sequencing of the variable domain of the heavy chain of immunoglobulin genes to measure changes in B cell repertoires in 19 highly HLA-sensitized kidney transplant candidates undergoing desensitization and 7 controls with low to moderate HLA sensitization levels...
January 13, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28069404/calculated-panel-reactive-antibody-with-decimals-a-refined-metric-of-access-to-transplantation-for-highly-sensitized-candidates
#4
Evan P Kransdorf, Marcelo J Pando
The use of the calculated panel reactive antibody (CPRA) value and the implementation of allocation points for sensitized candidates by the United Network for Organ Sharing (UNOS) have improved access to kidney transplantation for highly sensitized candidates (98% CPRA and above). Despite this, a large population of highly sensitized candidates remain awaiting transplantation. To better define this population, we propose the use of two refinements of the standard UNOS CPRA, the CPRA with decimals or CPRAd, and the likelihood of a compatible donor (LCD)...
January 6, 2017: Human Immunology
https://www.readbyqxmd.com/read/28052609/optn-srtr-2015-annual-data-report-kidney
#5
A Hart, J M Smith, M A Skeans, S K Gustafson, D E Stewart, W S Cherikh, J L Wainright, A Kucheryavaya, M Woodbury, J J Snyder, B L Kasiske, A K Israni
The first full year of data after implementation of the new kidney allocation system reveals an increase in deceased donor kidney transplants among black candidates and those with calculated panel-reactive antibodies 98%-100%, but a decrease among candidates aged 65 years or older. Data from 2015 also demonstrate ongoing positive trends in graft and patient survival for both deceased and living donor kidney transplants, but the challenges of a limited supply of kidneys in the setting of increasing demand remain evident...
January 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28009780/kidney-transplant-with-low-levels-of-dsa-or-low-positive-b-flow-crossmatch-an-underappreciated-option-for-highly-sensitized-transplant-candidates
#6
Carrie Schinstock, Manish Gandhi, Wisit Cheungpasitporn, Donald Mitema, Mikel Prieto, Patrick Dean, Lynn Cornell, Fernando Cosio, Mark Stegall
BACKGROUND: Avoiding donor specific antibody (DSA) is difficult for sensitized patients. Improved understanding of the risk of low level DSA is needed. METHODS: We retrospectively compared the outcomes of 954 patients transplanted with varied levels of baseline DSA detected by single antigen beads and B flow cytometric crossmatch (XM). Patients were grouped as follows: -DSA/-XM, +DSA/-XM, +DSA/low+XM, +DSA/high+XM, and -DSA/+XM and followed for a mean of 4.1±1...
December 22, 2016: Transplantation
https://www.readbyqxmd.com/read/27988992/outcomes-in-the-highest-panel-reactive-antibody-recipients-of-deceased-donor-kidneys-under-the-new-kidney-allocation-system
#7
Sandesh Parajuli, Robert R Redfield, Brad C Astor, Arjang Djamali, Dixon Kaufman, Didier A Mandelbrot
Since the institution of the new kidney allocation system in December 2014, kidney transplant candidates with the highest calculated panel reactive antibodies (cPRA) of 99-100 have been transplanted at much higher rates. However, concerns have been raised that outcomes in these patients might be impaired due to higher immunological risk and longer cold ischemia times resulting from long-distance sharing of kidneys. Here we compare outcomes at the University of Wisconsin between study patients with cPRA 99-100 and all other recipients of deceased donor kidneys transplanted between 12/04/2014 and12/31/2015...
December 17, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27955974/increased-access-to-transplantation-of-highly-sensitized-patients-under-the-new-kidney-allocation-system-a-single-center-experience
#8
Adriana I Colovai, Maria Ajaimy, Layla G Kamal, Peter Masiakos, Shirley Chan, Christina Savchik, Michelle Lubetzky, Graciela de Boccardo, Alesa Courson, Attasit Chokechanachaisakul, Jay Graham, Stuart Greenstein, Milan Kinkhabwala, Juan Rocca, Enver Akalin
We aimed to investigate the impact of the new kidney allocation system (KAS) on the rate of transplantation of sensitized patients at our center. Pre-KAS and post-KAS intervals were Jan 1(st) to Dec 3(rd) 2014 and Jan 1(st) 2015 to Dec 3(rd) 2015, respectively. The number of deceased-donor crossmatches performed by flow cytometry increased from 715 pre-KAS to 1188 post-KAS. The percent of crossmatches performed for sensitized patients with calculated panel reactive antibody (cPRA) >0% increased from 19% pre-KAS to 26% post-KAS (p<0...
December 9, 2016: Human Immunology
https://www.readbyqxmd.com/read/27932102/kidney-transplantation-results-in-very-highly-sensitized-patients-included-in-a-virtual-crossmatch-program-analysis-of-kidney-pairs
#9
A Mazuecos, A Alvarez, A Nieto, M A Gentil, M Cabello, A Rodriguez-Benot, C Gracia, F Gonzalez, P Castro, M Alonso
BACKGROUND: Kidney transplantation in highly-sensitized (HS) patients can improve with organ-exchange strategies based on virtual crossmatch (V-XM). Experience in very-HS patients is limited. METHODS: In June 2012, Andalusia started a V-XM protocol for very-HS patients (calculated panel reactive antibodies ≥95%). After organ allocation a cytotoxic-XM performed immediately before transplantation had to be negative for surgery to proceed. We analyzed results up until December 2015...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932095/implementation-of-a-national-priority-allocation-system-for-hypersensitized-patients-in-spain-based-on-virtual-crossmatch-initial-results
#10
M O Valentin, J C Ruiz, R Vega, C Martín, R Matesanz
Access to kidney transplantation for patients with high levels of antibodies against HLA is a major challenge. This issue makes it difficult to detect compatible donors for those patients in a certain geographical area. Consequently, hypersensitized patients remain on the waiting list for long periods and their quality of life deteriorates. Our purpose was to increase access to transplantation for highly sensitized patients by developing a national priority allocation system based on virtual crossmatch. Between June 15, 2015, and May 15, 2016, 675 patients on the kidney transplant waiting list with calculated panel-reactive antibodies ≥98% and undergoing dialysis for at least 12 months were included in the study; 86...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27890719/casting-a-smaller-net-into-a-bigger-donor-pool-a-single-center-s-experience-with-the-new-kidney-allocation-system
#11
Julie A Houp, Karl P Schillinger, Andrew J Eckstein, Renato M Vega, Niraj M Desai, Bonnie E Lonze, Annette M Jackson
The new kidney allocation system (KAS) provides additional allocation points for candidates with broad HLA sensitization in an effort to increase transplant rates for this underserved population. Following the implementation of KAS, our center lowered the HLA antibody threshold for listing unacceptable antigens from a cytotoxicity crossmatch level to a flow cytometric crossmatch level increasing Calculated Panel Reactive Antibody (CPRA) values and allocation points, yet restricting acceptable donor HLA phenotypes...
November 24, 2016: Human Immunology
https://www.readbyqxmd.com/read/27854236/correlation-of-bk-virus-neutralizing-serostatus-with-the-incidence-of-bk-viremia-in-kidney-transplant-recipients
#12
Johanna R Abend, Marguerite Changala, Atul Sathe, Fergal Casey, Amy Kistler, Sindhu Chandran, Abigail Howard, David Wojciechowski
BACKGROUND: BK virus (BKV)-associated nephropathy is the second leading cause of graft loss in kidney transplant recipients. Due to the high prevalence of persistent infection with BKV in the general population, it is possible that either the transplant recipient or donor may act as the source of virus resulting in viruria and viremia. Although several studies suggest a correlation between donor-recipient serostatus and the development of BK viremia, specific risk factors for BKV-related complications in the transplant setting remain to be established...
June 1, 2016: Transplantation
https://www.readbyqxmd.com/read/27801681/immunological-effect-of-skin-allograft-in-burn-treatment-impact-on-future-vascularized-composite-allotransplantation
#13
Rebecca M Garza, Barry H Press, Dolly B Tyan, Yvonne L Karanas, Gordon K Lee
Skin allografts are the benchmark in temporary burn wound coverage, but allografts are hypothesized to place a high antigenic load on recipients. This project aims to determine the degree of human leukocyte antigen sensitization in burn patients treated with allografts. Serum was obtained from nine adult, nontransfused, and nontransplanted burn patients treated with allografts. Group 1 included patients tested in the acute burn period, while group 2 included different patients tested months to years after injury...
October 27, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27647555/low-transplantability-of-0-blood-group-and-highly-sensitized-candidates-in-the-portuguese-kidney-allocation-algorithm-quantifying-an-old-problem-in-search-of-new-solutions
#14
S Tafulo, J Malheiro, L Dias, C Mendes, E Osório, L S Martins, J Santos, S Pedroso, M Almeida, A Castro-Henriques
The impact of patient's biological differences in waiting time for kidney transplantation is well known and has been a subject of extensive debate and struggle in transplantation community. Our purpose was to evaluate patient's access to kidney transplantation in Portugal, regarding their degree of allosensitization and blood type. A retrospective cohort study including 1020 candidates for kidney transplantation between 01 January 2010 and 31 December 2011 in transplant unit Centro Hospitalar do Porto was performed...
November 2016: HLA
https://www.readbyqxmd.com/read/27569922/estimating-waiting-time-for-deceased-donor-renal-transplantion-in-the-era-of-new-kidney-allocation-system
#15
F Torlak, M U S Ayvaci, M E Ahsen, C Arce, M A Vazquez, B Tanriover
BACKGROUND: On December 4, 2014, a new deceased donor kidney allocation system (KAS) was implemented. The KAS was designed to improve organ equity and graft-recipient longevity matching. However, estimated wait-time to deceased donor transplantation is difficult to predict post-KAS. METHODS: Using the Kidney-Pancreas Simulated Allocation Model software (KPSAM), a program that the Organ Procurement and Transplant Network uses to assess policy proposals, we compared the kidney allocations of both the new (post-KAS) and old policies (pre-KAS) (10 iterations for each group; total N = 204,148) and estimated wait-time based on blood type, duration of dialysis exposure, and calculated panel-reactive antibody (CPRA)...
July 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27379560/32-doses-of-bortezomib-for-desensitization-is-not-well-tolerated-and-is-associated-with-only-modest-reductions-in-anti-hla-antibody
#16
Manuel A Moreno Gonzales, Manish J Gandhi, Carrie A Schinstock, Natalie A Moore, Byron H Smith, Nong Y Braaten, Mark D Stegall
BACKGROUND: We previously showed that bortezomib (BTZ) partially depletes plasma cells, yet has limited efficacy for desensitization in kidney transplant candidates when up to 16 doses is given. METHODS: This study aimed to determine the safety and efficacy of 32 doses of BTZ (1.3 mg/m of body surface area) in 10 highly sensitized kidney transplant candidates with alloantibodies against their intended living donor. RESULTS: Dose reduction was needed in 2 patients and 2 others completely discontinued therapy for adverse events...
July 1, 2016: Transplantation
https://www.readbyqxmd.com/read/27362312/effect-of-induction-therapy-on-graft-survival-in-primary-pediatric-heart-transplantation-a-propensity-score-analysis-of-the-unos-database
#17
Ryan Butts, Melanie Davis, Andrew Savage, Ali Burnette, Minoo Kavarana, Scott Bradley, Andrew Atz, Paul J Nietert
BACKGROUND: The use of induction therapy in pediatric heart transplantation has increased. The aim of this study was to investigate the effects of induction therapy on graft survival. METHODS: The United Network for Organ Sharing database was queried for isolated pediatric heart transplants from January 1, 1994, to December 31, 2013. Propensity scores for induction treatment were calculated by estimating probability of induction using a logistic regression model...
June 29, 2016: Transplantation
https://www.readbyqxmd.com/read/27316382/immunologic-effects-of-continuous-flow-left-ventricular-assist-devices-before-and-after-heart-transplant
#18
Byung-Soo Ko, Stavros Drakos, Abdallah G Kfoury, Denise Hurst, Gregory J Stoddard, Carrie A Willis, Julio C Delgado, Elizabeth H Hammond, Edward M Gilbert, Rami Alharethi, Monica P Revelo, Jose Nativi-Nicolau, Bruce B Reid, Stephen H McKellar, Omar Wever-Pinzon, Dylan V Miller, David D Eckels, James C Fang, Craig H Selzman, Josef Stehlik
BACKGROUND: Immune allosensitization can be triggered by continuous-flow left ventricular assist devices (CF LVAD). However, the effect of this type of allosensitization on post-transplant outcomes remains controversial. This study examined the post-transplant course in a contemporary cohort of patients undergoing transplantation with and without LVAD bridging. METHODS: We included consecutive patients who were considered for cardiac transplant from 2006 to 2015...
August 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27286174/beyond-median-waiting-time-development-and-validation-of-a-competing-risk-model-to-predict-outcomes-on-the-kidney-transplant-waiting-list
#19
Allyson Hart, Nicholas Salkowski, Jon J Snyder, Ajay K Israni, Bertram L Kasiske
BACKGROUND: Median historical time to kidney transplant is misleading because it does not convey the competing risks of death or removal from the waiting list. We developed and validated a competing risk model to calculate likelihood of outcomes for kidney transplant candidates and demonstrate how this information differs from median time to transplant. METHODS: Data were obtained from the US Scientific Registry of Transplant Recipients. The retrospective cohort included 163 636 adults listed for kidney transplant before December 31, 2011...
July 2016: Transplantation
https://www.readbyqxmd.com/read/27234731/evaluation-of-changes-in-new-calculated-panel-reactive-antibody-adopting-hla-cw-dr51-52-53-and-dq-antigens-in-koreans
#20
J W In, E Y Roh, S Shin, K U Park, E Y Song
BACKGROUND: Calculated panel reactive antibody (cPRA) (%) is percentage of donors that would be incompatible with the candidate, based on the candidate's unacceptable HLA antigens. cPRA based on antigen frequencies of HLA-A, B, and DR has been used in Korea. We developed new cPRA including HLA-Cw, DR51/52/53, and DQ. Changes in new-cPRA were evaluated. METHODS: We analyzed the differences between cPRA based on HLA-A, -B, and -DR antigens (old-cPRA) from cPRA based on HLA-A, -B, -Cw, -DR, -DR51/52/53, and -DQ antigens (new-cPRA) on 125 waitlisted candidates for renal transplantation in Seoul National University Hospital...
April 2016: Transplantation Proceedings
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