Kidney Week

Abstract: SA-PO057

One-Year Outcome Experience of Deceased Donor Kidney Transplantation Post-KAS Implementation

Session Information

• Transplantation: Recipient and Donor Assessment
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Singh, Priyamvada, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States

Priyamvada Singh,

• Bucktowarsing, Bhavnish, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States

Bhavnish Bucktowarsing,

• Von Visger, Jon R., The Ohio State University Wexner Medical Center, Columbus, Ohio, United States

Jon R. Von Visger,

• Nori, Uday S., The Ohio State University Wexner Medical Center, Columbus, Ohio, United States

Uday S. Nori,

• Parekh, Hemant K., Ohio State University Wexner Medical Center, Columbus, Ohio, United States

Hemant K. Parekh,

• Pesavento, Todd E., The Ohio State University Wexner Medical Center, Columbus, Ohio, United States

Todd E. Pesavento,

• Diez, Alejandro, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States

Alejandro Diez,

Background

The new kidney allocation system (KAS) implemented on December 4, 2014, has a goal to improve access to transplant for under represented groups, such as the highly sensitized patients (calculated panel reactive antibodies, cPRA ≥90%).

Methods

We performed a single-center retrospective review of transplants performed on highly sensitized recipients and compared outcomes, in relation to the implementation of KAS.

Results

164 DDKT were performed in 22 months prior to KAS implementation whereas 187 were performed 22 months post-KAS implementation. Out of 351 transplants during this period, 33 had a PRA of ≥ 90% (11 pre-KAS, 22 Post) and 14 had a PRA of 100% (2 Pre, 12 Post) consistent with the bolus effects seen in the previous reports. We also compared the one-year outcomes of patients with ‘0’ cPRA with ≥ 90% CPRA. Out of 148 patients selected between periods of December 2014 to October 2016, 126 had cPRA of 0% and 22 had a cPRA of ≥ 90. All patients had at least one-year post-transplant follow up. We didn’t find any significant differences in primary outcomes of graft survival, all-cause mortality, delayed graft function and return to dialysis (table 1). Cold ischemia time was significantly higher post KAS possibly owing to a greater regional sharing (table 2). Although biopsy-proven rejection was more prevalent in highly sensitized patients compared to non-sensitized it was not statistically significant. Unlike previously published reports, we didn’t find any difference in outcomes among the two groups based on waitlist time and time on dialysis. Additionally, duration of hospital stay, readmissions and serum creatinine was similar in both groups.

Conclusion

Results are reassuring as we found no differences in outcomes between both groups but it still warrants long-term follow up.