Scandiatransplant acceptable mismatch program (STAMP) a bridge to transplanting highly immunized patients

Nordic Kidney group and the Tissue Typing group in Scandiatransplant

doi:10.1111/tan.13046

Scandiatransplant acceptable mismatch program (STAMP) a bridge to transplanting highly immunized patients

Nordic Kidney group and the Tissue Typing group in Scandiatransplant

Department of Clinical Medicine

2 Citations (Scopus)

Abstract

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.

Original language	English
Journal	HLA
Volume	90
Issue number	1
Pages (from-to)	17-24
Number of pages	8
ISSN	2059-2302
DOIs	https://doi.org/10.1111/tan.13046
Publication status	Published - Jul 2017

Keywords

ABO Blood-Group System/genetics
Female
Gene Expression
Graft Rejection/prevention & control
Graft Survival
HLA Antigens/classification
Histocompatibility Testing/methods
Humans
Isoantibodies/biosynthesis
Kidney Transplantation
Male
Middle Aged
Scandinavian and Nordic Countries
Tissue Donors/classification
Tissue and Organ Procurement/statistics & numerical data
Transplant Recipients/classification
Transplantation, Homologous

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10.1111/tan.13046

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@article{42ed146ae7594a9e89823c2f2b8ab4d9,

title = "Scandiatransplant acceptable mismatch program (STAMP) a bridge to transplanting highly immunized patients",

abstract = "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.",

keywords = "ABO Blood-Group System/genetics, Female, Gene Expression, Graft Rejection/prevention & control, Graft Survival, HLA Antigens/classification, Histocompatibility Testing/methods, Humans, Isoantibodies/biosynthesis, Kidney Transplantation, Male, Middle Aged, Scandinavian and Nordic Countries, Tissue Donors/classification, Tissue and Organ Procurement/statistics & numerical data, Transplant Recipients/classification, Transplantation, Homologous",

author = "P Koefoed-Nielsen and I Weinreich and M Bengtsson and J Lauronen and C Naper and M G{\"a}bel and S{\o}rensen, {S S} and L Wennberg and Reisaeter, {A V} and M{\o}ller, {B K} and {Nordic Kidney group and the Tissue Typing group in Scandiatransplant}",

note = "{\textcopyright} 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",

year = "2017",

month = jul,

doi = "10.1111/tan.13046",

language = "English",

volume = "90",

pages = "17--24",

journal = "HLA",

issn = "2059-2302",

publisher = "Wiley-Blackwell",

number = "1",

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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

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 -

Scandiatransplant acceptable mismatch program (STAMP) a bridge to transplanting highly immunized patients

Abstract

Keywords

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