Open AccessFor the many: permitting deceased donor kidney transplantation across low‐titre blood group antibodies can reduce wait times for blood group B recipients, and improve the overall number of 000 MM transplants ‐ a multicentre observational cohort study
Author(s) -
Manook Miriam,
Mumford Lisa,
Barnett Alec Nicholas R.,
OseiBordom Daniel,
Sandhu Bynvant,
Veniard David,
Maggs Tim,
Shaw Olivia,
Kessaris Nicos,
Dorling Anthony,
Shah Sapna,
Mamode Nizam
Publication year - 2019
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13389
Subject(s) - medicine , group b , kidney transplantation , blood donor , group a , antibody , transplantation , titer , isoantibodies , immunology
Summary Blood group O or B recipients wait longer for a kidney transplant. We studied the distribution of anti‐ ABO blood group antibody titres in patients awaiting a kidney transplant, and modelled the effect of altering the UK National Kidney Allocation Scheme to allow for patients with ‘ LOW ’ titres (≤1:8, ≤3 dilutions) to receive a deceased donor ABO i (dd ABO i) transplant. In a prospective study of 239 adult patients on the waiting list for a transplant in 2 UK centres, ABO ‐antibody titres (anti‐A and anti‐B) were measured. Based on the proportions of ‘ LOW ’ anti‐A or anti‐B antibodies, four simulations were performed to model the current allocation rules compared with variations allowing dd ABO i allocation under various conditions of blood group, HLA matching, and waiting time. The simulations permitting dd ABO i resulted in more blood group B recipients being transplanted, with median waiting time reduced for this group of recipients, and more equitable waiting times across blood groups. Additionally, permitting dd ABO i resulted in greater numbers of 000 MM allocations overall in compatible transplants under modelled conditions. Changing allocation in the UK to permit dd ABO i in patients with ‘ LOW ’ titres would not change the total number of transplants, but redistributes allocation more equitably amongst blood groups, altering waiting times accordingly.