新的肾脏分配系统并非对所有高交叉配型反应抗体（cPRA）的候选者都具有同等优势——一项单中心分析。
The new kidney allocation system does not equally advantage all very high cPRA candidates - A single center analysis.
作者信息
Hahn Amy B, Mackey Maryanne, Constantino Don, Ata Ashar, Chandolias Nikolaos, Lopez-Soler Reynold, Conti David J
机构信息
Transplantation Immunology Laboratory, Department of Surgery, Albany Medical College, 47 New Scotland Avenue, Albany, NY 12208, USA.
Transplantation Immunology Laboratory, Department of Surgery, Albany Medical College, 47 New Scotland Avenue, Albany, NY 12208, USA.
出版信息
Hum Immunol. 2017 Jan;78(1):37-40. doi: 10.1016/j.humimm.2016.10.010. Epub 2016 Oct 19.
The new UNOS kidney allocation system awards very high points to candidates with cPRA 99% and 100%, and allows for national sharing for cPRA 100% candidates. We sought to determine the effect of this new kidney allocation system on candidates who are very highly sensitized (90-98% cPRA) but not eligible for very high points or national sharing by examining offers to these candidates for 5months pre-implementation and two consecutive 5month periods post-implementation and comparing them to cPRA⩾99% candidates. We found that the cPRA⩾99% candidates received significantly more offers and transplants after implementation, while offers and transplants to the 90-98% candidates decreased. A slight adjustment to the allocation system may be needed to provide more equitable distribution of kidneys to all high cPRA candidates.
新的器官共享联合网络（UNOS）肾脏分配系统给致敏概率（cPRA）为99%和100%的候选人极高的分数，并允许cPRA为100%的候选人在全国范围内共享肾脏。我们试图通过检查实施前5个月以及实施后连续两个5个月期间向这些候选人提供的肾脏情况，并将其与cPRA⩾99%的候选人进行比较，来确定这种新的肾脏分配系统对致敏程度非常高（cPRA为90 - 98%）但不符合获得极高分数或全国共享条件的候选人的影响。我们发现，cPRA⩾99%的候选人在实施后获得了显著更多的肾脏提供和移植，而cPRA为90 - 98%的候选人获得的肾脏提供和移植则减少了。可能需要对分配系统进行轻微调整，以便更公平地向所有高cPRA的候选人分配肾脏。
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