Aim The new Kidney Allocation System (KAS) provides additional allocation points for sensitized candidates in an effort to increase transplant rates for this underserved population Following the implementation of KAS, our center lowered the HLA antibody threshold for listing unacceptable antigens from a cytotoxicity level to a flow cytometric crossmatch level. The aim of this study was to assess the effect of KAS following CPRA optimization for our renal waitlist candidates. Methods We examined renal transplants that occurred 11 months prior and post CPRA optimization. We investigated transplant numbers per CPRA category; the average number of Donor Specific Antibodies (DSAs) at transplant; the number of post-transplant specimens submitted, and Virtual Crossmatch (VXM) requests for high CPRA (>97) patients. Results During an 11 month period prior to CPRA optimization our center performed 105 deceased donor transplants. Of these, 84.76% were patients with a CPRA value of 0, while 1.04% were patients with high CPRA values (>97%). Of the 175 deceased donor transplants performed after our laboratory’s CPRA optimization, 26.38% were patients with a CPRA >97%. Transplanted individuals with a 0% CPRA decreased to 57.67%. Patients transplanted pre-optimization versus post-optimization submitted an average of 12 and 48.5 samples per month, respectively. Patients transplanted pre-optimization and post-optimization had an average of 0.46 and 0.47 donor specific antibodies, respectively. Our instances of VXM requests for high CPRA patients more than tripled following the implantation of KAS. VXM numbers: October 2014 (0), April 2015 (10), October 2015 (29), April 2016 (36). Conclusions More high CPRA patients are being transplanted following implementation of KAS. Our laboratory has experienced an increase in VXM assessments and post-transplant DSA testing received while experiencing similar numbers of DSAs prior to transplant. Download : Download high-res image (72KB) Download : Download full-size image
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