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Stem cell donor HLA typing improves CPRA in kidney allocation
Author(s) -
Kransdorf Evan P.,
Pando Marcelo J.,
Stewart Darren,
Lindblad Kelsi,
Bray Robert,
Murphey Cathi,
Kaur Navchetan,
Patel Jignesh K.,
Kim Irene,
Zhang Xiaohai,
Maiers Martin,
Kobashigawa Jon A.,
Gragert Loren
Publication year - 2021
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.16156
Subject(s) - medicine , human leukocyte antigen , kidney transplantation , haplotype , transplantation , immunology , antigen , genetics , allele , biology , gene
The Organ Procurement and Transplantation Network (OPTN) Kidney Allocation System provides a priority to sensitized candidates based on the calculated panel reactive antibody (CPRA) value. The human leukocyte antigen (HLA) haplotype reference panel used for calculation of the CPRA by the United Network for Organ Sharing (UNOS), the OPTN contractor, has limitations. We derived a novel panel from the National Marrow Donor Program HLA haplotype data set and compared the accuracy of CPRA values generated with this panel (NMDP‐CPRA) to those generated from the UNOS panel (UNOS‐CPRA), using predicted and actual deceased donor kidney offers for a cohort of 24 282 candidates. The overall accuracy for kidney offers was similar using NMDP‐CPRA and UNOS‐CPRA. Accuracy was slightly higher for NMDP‐CPRA than UNOS‐CPRA for candidates in several highly sensitized CPRA categories, with deviations in linkage disequilibrium for Caucasians and the smaller size of the UNOS panel as contributing factors. HLA data derived from stem cell donors yields CPRA values that are comparable to those derived from deceased kidney donors while improving upon several problems with the current reference panel. Consideration should be given to using stem cell donors as the reference panel for calculation of CPRA to improve equity in kidney transplant allocation.