TY - JOUR
T1 - Scandiatransplant acceptable mismatch program (STAMP) a bridge to transplanting highly immunized patients
AU - Koefoed-Nielsen, P
AU - Weinreich, I
AU - Bengtsson, M
AU - Lauronen, J
AU - Naper, C
AU - Gäbel, M
AU - Sørensen, S S
AU - Wennberg, L
AU - Reisaeter, A V
AU - Møller, B K
AU - Nordic Kidney group and the Tissue Typing group in Scandiatransplant
N1 - © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2017/7
Y1 - 2017/7
N2 - BACKGROUND: Highly immunized patients are a challenge for organ transplantation programs. One way of increasing the likelihood of transplantation in this group of patients is to expand the possible donations by defining acceptable HLA mismatches. In the Scandiatransplant Acceptable Mismatch Program (STAMP), a de-centralized approach has been implemented in 2009.AIMS: The program has been improved during the years from utilizing HLA-A, -B, -DR matching only to include typing of all deceased donors for HLA-A, -B, -C, -DRB1 and -DQB1. The calculation of a transplantability score (TS) has been introduced in order to take both HLA and AB0 into consideration resulting in a more realistic picture of the transplantability chance.MATERIALS AND METHODS: Patients were selected for eligibility and results of immunisation status were prepared in each of the 9 tissue typing laboratories, while access to the program is finally governed by a common steering group of immunologists and clinicians.RESULTS: In the period from March 2009 until February 2015, 96 patients were transplanted within this program. The mean recipient age was 49 years and 57% were females, 30% of the patients were first transplants and of these 93% were females. The majority of the patients had 2-5 HLA-A, -B. -DR mismatches. The allograft survival at 60 months was 79.1%. Applying the TS to the cohort confirmed that patients with a low TS score had longer waiting times.CONCLUSION: The program has matured during the years and now proves to be a valid approach for transplanting highly immunized patients.
AB - BACKGROUND: Highly immunized patients are a challenge for organ transplantation programs. One way of increasing the likelihood of transplantation in this group of patients is to expand the possible donations by defining acceptable HLA mismatches. In the Scandiatransplant Acceptable Mismatch Program (STAMP), a de-centralized approach has been implemented in 2009.AIMS: The program has been improved during the years from utilizing HLA-A, -B, -DR matching only to include typing of all deceased donors for HLA-A, -B, -C, -DRB1 and -DQB1. The calculation of a transplantability score (TS) has been introduced in order to take both HLA and AB0 into consideration resulting in a more realistic picture of the transplantability chance.MATERIALS AND METHODS: Patients were selected for eligibility and results of immunisation status were prepared in each of the 9 tissue typing laboratories, while access to the program is finally governed by a common steering group of immunologists and clinicians.RESULTS: In the period from March 2009 until February 2015, 96 patients were transplanted within this program. The mean recipient age was 49 years and 57% were females, 30% of the patients were first transplants and of these 93% were females. The majority of the patients had 2-5 HLA-A, -B. -DR mismatches. The allograft survival at 60 months was 79.1%. Applying the TS to the cohort confirmed that patients with a low TS score had longer waiting times.CONCLUSION: The program has matured during the years and now proves to be a valid approach for transplanting highly immunized patients.
KW - ABO Blood-Group System/genetics
KW - Female
KW - Gene Expression
KW - Graft Rejection/prevention & control
KW - Graft Survival
KW - HLA Antigens/classification
KW - Histocompatibility Testing/methods
KW - Humans
KW - Isoantibodies/biosynthesis
KW - Kidney Transplantation
KW - Male
KW - Middle Aged
KW - Scandinavian and Nordic Countries
KW - Tissue Donors/classification
KW - Tissue and Organ Procurement/statistics & numerical data
KW - Transplant Recipients/classification
KW - Transplantation, Homologous
U2 - 10.1111/tan.13046
DO - 10.1111/tan.13046
M3 - Journal article
C2 - 28449350
SN - 2059-2302
VL - 90
SP - 17
EP - 24
JO - HLA
JF - HLA
IS - 1
ER -