Kransdorf Evan P, Pando Marcelo J
Cedars-Sinai Heart Institute, Beverly Hills, CA, USA.
Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix, AZ, USA.
Hum Immunol. 2017 Mar;78(3):252-256. doi: 10.1016/j.humimm.2016.12.009. Epub 2017 Jan 6.
The use of the calculated panel reactive antibody (CPRA) value and the implementation of allocation points for sensitized candidates by the United Network for Organ Sharing (UNOS) have improved access to kidney transplantation for highly sensitized candidates (98% CPRA and above). Despite this, a large population of highly sensitized candidates remain awaiting transplantation. To better define this population, we propose the use of two refinements of the standard UNOS CPRA, the CPRA with decimals or CPRAd, and the likelihood of a compatible donor (LCD). These refined metrics of the standard UNOS CPRA will allow transplant programs to describe their patients' access to transplantation with increased granularity and will help in decisions regarding the use of desensitization.
通过使用计算得出的群体反应性抗体（CPRA）值以及器官共享联合网络（UNOS）为致敏候选者实施分配点数，高度致敏候选者（CPRA为98%及以上）接受肾移植的机会有所增加。尽管如此，仍有大量高度致敏候选者在等待移植。为了更好地界定这一群体，我们建议对标准的UNOS CPRA进行两项改进，即带小数的CPRA或CPRAd，以及找到相容性供体的可能性（LCD）。这些对标准UNOS CPRA的细化指标将使移植项目能够更细致地描述其患者接受移植的机会，并有助于在脱敏治疗的使用方面做出决策。
