PMID- 35975734
OWN - NLM
STAT- MEDLINE
DCOM- 20221205
LR  - 20230413
IS  - 1600-6143 (Electronic)
IS  - 1600-6135 (Print)
IS  - 1600-6135 (Linking)
VI  - 22
IP  - 12
DP  - 2022 Dec
TI  - ABO-adjusted calculated panel reactive antibody (cPRA): A unified metric for 
      immunologic compatibility in kidney transplantation.
PG  - 3093-3100
LID - 10.1111/ajt.17175 [doi]
AB  - Implementation of the kidney allocation system in 2014 greatly reduced access 
      disparity due to human leukocyte antigen (HLA) sensitization. To address 
      persistent disparity related to candidate ABO blood groups, herein we propose a 
      novel metric termed "ABO-adjusted cPRA," which simultaneously considers the 
      impact of candidate HLA and ABO sensitization on the same scale. An 
      ethnic-weighted ABO-adjusted cPRA value was computed for 190 467 candidates on 
      the kidney waitlist by combining candidate's conventional HLA cPRA with the 
      remaining fraction of HLA-compatible donors that are ABO-incompatible. 
      Consideration of ABO sensitization resulted in higher ABO-adjusted cPRA relative 
      to conventional cPRA by HLA alone, except for AB candidates since they are not 
      ABO-sensitized. Within cPRA Point Group = 99%, 43% of the candidates moved up to 
      ABO-adjusted cPRA Point Group = 100%, though this proportion varied substantially 
      by candidate blood group. Nearly all O and most B candidates would have elevated 
      ABO-adjusted cPRA values above this policy threshold for allocation priority, but 
      relatively few A candidates displayed this shift. Overall, ABO-adjusted cPRA more 
      accurately measures the proportion of immune-compatible donors compared with 
      conventional HLA cPRA, especially for highly sensitized candidates. 
      Implementation of this novel metric could enable the development of allocation 
      policies permitting more ABO-compatible transplants without compromising equity.
CI  - (c) 2022 The Authors. American Journal of Transplantation published by Wiley 
      Periodicals LLC on behalf of The American Society of Transplantation and the 
      American Society of Transplant Surgeons.
FAU - Gragert, Loren
AU  - Gragert L
AUID- ORCID: 0000-0002-5945-6518
AD  - Department of Pathology and Laboratory Medicine, Tulane University School of 
      Medicine, New Orleans, Louisiana, USA.
FAU - Kadatz, Matthew
AU  - Kadatz M
AUID- ORCID: 0000-0003-1119-9724
AD  - Vancouver Coastal Health Research Institute, Vancouver, Canada.
AD  - Division of Nephrology, University of British Columbia, Vancouver, Canada.
FAU - Alcorn, James
AU  - Alcorn J
AUID- ORCID: 0000-0002-7991-335X
AD  - United Network for Organ Sharing, Richmond, Virginia, USA.
FAU - Stewart, Darren
AU  - Stewart D
AUID- ORCID: 0000-0002-6764-4842
AD  - United Network for Organ Sharing, Richmond, Virginia, USA.
FAU - Chang, Doris
AU  - Chang D
AD  - Providence Health Research Institute, Vancouver, Canada.
FAU - Gill, Jagbir
AU  - Gill J
AD  - Division of Nephrology, University of British Columbia, Vancouver, Canada.
AD  - Providence Health Research Institute, Vancouver, Canada.
AD  - Centre for Health Evaluation and Outcomes Sciences, University of British 
      Columbia, Vancouver, Canada.
FAU - Liwski, Robert
AU  - Liwski R
AD  - Department of Pathology, Dalhousie University, Halifax, Canada.
FAU - Gebel, Howard M
AU  - Gebel HM
AUID- ORCID: 0000-0003-0197-2752
AD  - Department of Pathology, Emory University, Atlanta, Georgia, USA.
FAU - Gill, John
AU  - Gill J
AUID- ORCID: 0000-0002-8837-6875
AD  - Division of Nephrology, University of British Columbia, Vancouver, Canada.
AD  - Providence Health Research Institute, Vancouver, Canada.
FAU - Lan, James H
AU  - Lan JH
AUID- ORCID: 0000-0002-1710-3810
AD  - Vancouver Coastal Health Research Institute, Vancouver, Canada.
AD  - Division of Nephrology, University of British Columbia, Vancouver, Canada.
AD  - Department of Pathology and Laboratory Medicine, University of British Columbia, 
      Vancouver, Canada.
LA  - eng
GR  - U01 AI152960/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20220830
PL  - United States
TA  - Am J Transplant
JT  - American journal of transplantation : official journal of the American Society of 
      Transplantation and the American Society of Transplant Surgeons
JID - 100968638
RN  - 0 (HLA Antigens)
RN  - 0 (Antibodies)
SB  - IM
MH  - Humans
MH  - *Kidney Transplantation/methods
MH  - *Tissue and Organ Procurement
MH  - HLA Antigens
MH  - Tissue Donors
MH  - Histocompatibility Testing/methods
MH  - Antibodies
PMC - PMC10087664
OTO - NOTNLM
OT  - ABO incompatibility
OT  - ethics and public policy
OT  - genetics
OT  - histocompatibility
OT  - immunogenetics
OT  - organ allocation
OT  - organ procurement and allocation
OT  - panel reactive antibody (PRA)
OT  - registry/registry analysis
OT  - translational research/science
EDAT- 2022/08/18 06:00
MHDA- 2022/12/06 06:00
PMCR- 2023/04/11
CRDT- 2022/08/17 06:13
PHST- 2022/07/17 00:00 [revised]
PHST- 2022/05/26 00:00 [received]
PHST- 2022/08/13 00:00 [accepted]
PHST- 2022/08/18 06:00 [pubmed]
PHST- 2022/12/06 06:00 [medline]
PHST- 2022/08/17 06:13 [entrez]
PHST- 2023/04/11 00:00 [pmc-release]
AID - S1600-6135(23)00061-8 [pii]
AID - AJT17175 [pii]
AID - 10.1111/ajt.17175 [doi]
PST - ppublish
SO  - Am J Transplant. 2022 Dec;22(12):3093-3100. doi: 10.1111/ajt.17175. Epub 2022 Aug 
      30.