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Article ; Online: Electrocardiography-based Artificial Intelligence Algorithms Aid in Prediction of Long-term Mortality After Kidney Transplantation.

Pencovich, Niv / Smith, Byron H / Attia, Zachi I / Jimenez, Francisco Lopez / Bentall, Andrew J / Schinstock, Carrie A / Khamash, Hasan A / Jadlowiec, Caroline C / Jarmi, Tambi / Mao, Shennen A / Park, Walter D / Diwan, Tayyab S / Friedman, Paul A / Stegall, Mark D

Transplantation

2024

Abstract: Background: Predicting long-term mortality postkidney transplantation (KT) using baseline clinical data presents significant challenges. This study aims to evaluate the predictive power of artificial intelligence (AI)-enabled analysis of preoperative ... ...

Abstract	Background: Predicting long-term mortality postkidney transplantation (KT) using baseline clinical data presents significant challenges. This study aims to evaluate the predictive power of artificial intelligence (AI)-enabled analysis of preoperative electrocardiograms (ECGs) in forecasting long-term mortality following KT. Methods: We analyzed preoperative ECGs from KT recipients at three Mayo Clinic sites (Minnesota, Florida, and Arizona) between January 1, 2006, and July 30, 2021. The study involved 6 validated AI algorithms, each trained to predict future development of atrial fibrillation, aortic stenosis, low ejection fraction, hypertrophic cardiomyopathy, amyloid heart disease, and biological age. These algorithms' outputs based on a single preoperative ECG were correlated with patient mortality data. Results: Among 6504 KT recipients included in the study, 1764 (27.1%) died within a median follow-up of 5.7 y (interquartile range: 3.00-9.29 y). All AI-ECG algorithms were independently associated with long-term all-cause mortality (P < 0.001). Notably, few patients had a clinical cardiac diagnosis at the time of transplant, indicating that AI-ECG scores were predictive even in asymptomatic patients. When adjusted for multiple clinical factors such as recipient age, diabetes, and pretransplant dialysis, AI algorithms for atrial fibrillation and aortic stenosis remained independently associated with long-term mortality. These algorithms also improved the C-statistic for predicting overall (C = 0.74) and cardiac-related deaths (C = 0.751). Conclusions: The findings suggest that AI-enabled preoperative ECG analysis can be a valuable tool in predicting long-term mortality following KT and could aid in identifying patients who may benefit from enhanced cardiac monitoring because of increased risk.
Language	English
Publishing date	2024-04-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	208424-7
ISSN	1534-6080 ; 0041-1337
ISSN (online)	1534-6080
ISSN	0041-1337
DOI	10.1097/TP.0000000000005023
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Zs.A 488: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Outcomes with transplanting kidneys offered through expedited allocation.

Jadlowiec, Caroline C / Ohara, Stephanie Y / Punukollu, Rachana / Wagler, Josiah / Ruch, Brianna / Kumm, Kayla / Budhiraja, Pooja / Me, Hay Me / Mathur, Amit K / Reddy, Kunam S / Khamash, Hasan / Heilman, Raymond

Clinical transplantation

2023 Volume 37, Issue 11, Page(s) e15094

Abstract: Introduction: Expedited out-of-sequence deceased donor kidney allocation is a strategy to avoid discards after early placement attempts have been unsuccessful. Our study aimed to assess outcomes and characteristics of these transplanted kidneys.: ... ...

Abstract	Introduction: Expedited out-of-sequence deceased donor kidney allocation is a strategy to avoid discards after early placement attempts have been unsuccessful. Our study aimed to assess outcomes and characteristics of these transplanted kidneys. Methods: KDPI matching was performed between expedited allocation (EA) and standard allocation (SA) deceased donor kidney transplants performed at our center. Results: Between 2018 and 2021, there were 225 EA offers, and 189 (84%) were transplanted. EA recipients were older (p = .007) and had shorter dialysis vintage (p < .0001). EA kidneys were likely to be nationally allocated (p < .001), have AKI (p < .0001) and longer CIT (p < .0001). There were no differences in EA and SA time-zero kidney biopsies (ci, p = .07; ct, p = .89; cv, p = .95; ah, p = .79). EA kidneys had more DGF (p = .0006), but there were no differences in DGF duration (p = .83), hospital length of stay (p = .43), 1- and 2-year eGFR (p = .16, p = .99), patient (p = .34), or death-censored graft (p = .66) survival. Conclusion: During this study period, our center transplanted 189 kidneys through EA following local-regional declines. These kidneys often came from AKI donors and had more DGF but had similar outcomes to KDPI-matched SA kidneys. Although it has been suggested that EA has the potential to worsen transplant disparities, transplant center level decisions on organ acceptance contribute to these variations.
MeSH term(s)	Humans ; Tissue and Organ Procurement ; Kidney Transplantation ; Graft Survival ; Kidney ; Tissue Donors ; Acute Kidney Injury
Language	English
Publishing date	2023-08-10
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	639001-8
ISSN	1399-0012 ; 0902-0063
ISSN (online)	1399-0012
ISSN	0902-0063
DOI	10.1111/ctr.15094
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Article ; Online: Utilizing kidneys from a donor with bile-cast nephropathy.

Me, Hay Me / Budhiraja, Pooja / Nair, Sumi / Kodali, Lavanya / Ryan, Margaret / Khamash, Hasan / Heilman, Raymond / Wagler, Josiah / Ruch, Brianna / Jadlowiec, Caroline C / Moss, Adyr / Reddy, Kunam S

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

2023 Volume 24, Issue 1, Page(s) 141–144

Abstract: Here we discuss the successful utilization of a pair of deceased donor kidneys with bile-cast nephropathy. The donor had a kidney donor profile index of 48% and an acute kidney injury requiring continuous renal replacement therapy. Peak donor bilirubin ... ...

Abstract	Here we discuss the successful utilization of a pair of deceased donor kidneys with bile-cast nephropathy. The donor had a kidney donor profile index of 48% and an acute kidney injury requiring continuous renal replacement therapy. Peak donor bilirubin was 40.5 mg/dL, and renal wedge biopsies showed bile-cast nephropathy. Both recipients had delayed graft function lasting up to 4 weeks. The 4-month biopsies showed mild interstitial fibrosis, tubular atrophy, and a resolution of bile casts. These kidney allografts showed the reversible course of cholemic nephropathy and the potential for increasing the utilization of previously discarded kidneys.
MeSH term(s)	Humans ; Bile ; Kidney/pathology ; Kidney Transplantation/adverse effects ; Acute Kidney Injury/etiology ; Transplantation, Homologous ; Tissue Donors ; Biopsy ; Graft Survival
Language	English
Publishing date	2023-08-25
Publishing country	United States
Document type	Case Reports
ZDB-ID	2060594-8
ISSN	1600-6143 ; 1600-6135
ISSN (online)	1600-6143
ISSN	1600-6135
DOI	10.1016/j.ajt.2023.08.018
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Article ; Online: Kidney Transplant in the Era of Modern Therapy for Multiple Myeloma.

Huskey, Janna L / Heilman, Raymond L / Khamash, Hasan / Fonseca, Rafael

Transplantation

2018 Volume 102, Issue 12, Page(s) 1994–2001

Abstract: Chronic kidney disease is common in patients with multiple myeloma. Historically, individuals with end-stage renal disease and multiple myeloma did poorly with renal transplantation due to higher mortality rates from the malignancy itself or associated ... ...

Abstract	Chronic kidney disease is common in patients with multiple myeloma. Historically, individuals with end-stage renal disease and multiple myeloma did poorly with renal transplantation due to higher mortality rates from the malignancy itself or associated comorbidities. However, over the past 2 decades, there have been significant advances in the treatment of multiple myeloma with the advent of new therapeutic agents resulting in an improvement of long-term survival. As a result, more individuals with multiple myeloma are being referred for kidney transplantation, especially those with good functional capacity and minimal comorbidities. Recent literature has suggested that certain patients with multiple myeloma can successfully undergo renal transplantation after stem transplantation with consideration for maintenance therapy, although caution should be used with immunomodulating drugs due to the anecdotally reported risk of acute rejection. Therefore, having a multidisciplinary approach with the transplant team and hematology both before and after transplant is crucial in maximizing the chance of success for these individuals. This review summarizes the literature on renal transplantation in patients with multiple myeloma as well as the therapeutic advancements that have occurred which may allow certain patients to undergo successful transplantation.
MeSH term(s)	Antineoplastic Agents/adverse effects ; Antineoplastic Agents/therapeutic use ; Antineoplastic Agents, Immunological/therapeutic use ; Clinical Decision-Making ; Graft Rejection/immunology ; Graft Rejection/prevention & control ; Graft Survival/drug effects ; Humans ; Immunologic Factors/therapeutic use ; Immunosuppressive Agents/therapeutic use ; Kidney Failure, Chronic/immunology ; Kidney Failure, Chronic/mortality ; Kidney Failure, Chronic/surgery ; Kidney Transplantation/adverse effects ; Kidney Transplantation/mortality ; Multiple Myeloma/immunology ; Multiple Myeloma/mortality ; Multiple Myeloma/therapy ; Patient Selection ; Proteasome Inhibitors/therapeutic use ; Risk Assessment ; Risk Factors ; Stem Cell Transplantation/adverse effects ; Stem Cell Transplantation/mortality ; Time Factors ; Treatment Outcome
Chemical Substances	Antineoplastic Agents ; Antineoplastic Agents, Immunological ; Immunologic Factors ; Immunosuppressive Agents ; Proteasome Inhibitors
Language	English
Publishing date	2018-09-13
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	208424-7
ISSN	1534-6080 ; 0041-1337
ISSN (online)	1534-6080
ISSN	0041-1337
DOI	10.1097/TP.0000000000002449
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Zs.A 488: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Overcoming Mismatch Concerns for Adult Recipients of Small Pediatric Deceased Donor Kidneys.

Das, Devika M / Heilman, Raymond L / Khamash, Hasan A / Mathur, Amit K / Singer, Andrew L / Reddy, Kunam S / Jadlowiec, Caroline C

Transplantation proceedings

2021 Volume 53, Issue 5, Page(s) 1509–1513

Abstract: Background: Kidneys from very young pediatric donors continue to be underutilized. To reduce discard, the Organ Procurement and Transplantation Network (OPTN) policy was recently updated to allow kidneys from donors weighing <18 kg to be recovered en ... ...

Abstract	Background: Kidneys from very young pediatric donors continue to be underutilized. To reduce discard, the Organ Procurement and Transplantation Network (OPTN) policy was recently updated to allow kidneys from donors weighing <18 kg to be recovered en bloc. Methods: We reviewed our center's experience with kidney transplantation in adult recipients of <18 kg pediatric donor kidneys to assess renal function outcomes specific to solitary vs en bloc usage. Results: The majority of <18 kg donors were used en bloc (n = 39, 72.2% vs n = 15, 27.8%). Donor weight (kg) was similar between the 2 groups (12.3 ± 3.2 vs 14.1 ± 2.5, P = .05). Recipient weight was lower in the solitary kidney group (P = .01). Both groups had a similar donor-to-recipient body weight ratio (0.24 ± 0.3 vs 0.18 ± 0.3, P = .51). The solitary kidney group had a lower estimated glomerular filtration rate at 1 (56.9 ± 24.3 vs 81.8 ± 24.8, P = .01) and 2 years (72 ± 18.6 vs 93.7 ± 21.6, P = .03). By 2 years, both groups had an average estimated glomerular filtration rate >60 mL/min. Kidney allograft growth occurred in both groups, with the largest increase occurring the first month posttransplant (11.9%, 18.6%, P < .0001). Conclusion: For pediatric donors weighing <18 kg, improvements in renal function continue beyond the first posttransplant year. Risk for hyperfiltration injury appears low and renal mass-recipient mass matching is useful in guiding decision-making for solitary vs en bloc utilization.
MeSH term(s)	Adult ; Body Weight ; Child ; Child, Preschool ; Donor Selection/methods ; Female ; Glomerular Filtration Rate ; Graft Survival/physiology ; Humans ; Kidney/pathology ; Kidney/physiopathology ; Kidney Transplantation/methods ; Male ; Middle Aged ; Retrospective Studies ; Tissue Donors/statistics & numerical data ; Tissue Donors/supply & distribution ; Tissue and Organ Procurement/methods ; Tissue and Organ Procurement/supply & distribution ; Transplants/pathology ; Transplants/physiopathology ; Treatment Outcome
Language	English
Publishing date	2021-04-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2021.03.030
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Zs.A 835: Show issues

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Article ; Online: Patient and allograft outcomes after kidney transplant for the Indigenous patients in the United States.

Seipp, Regan / Zhang, Nan / Nair, Sumi Sukumaran / Khamash, Hasan / Sharma, Amit / Leischow, Scott / Heilman, Raymond / Keddis, Mira T

PloS one

2021 Volume 16, Issue 2, Page(s) e0244492

Abstract: Background: The objective is to assess cardiovascular (CV), malignancy, infectious, graft outcomes and tacrolimus levels for the Indigenous patients compared to Whites after kidney transplant (KTx).: Methods: 165 Indigenous and 165 White patients ... ...

Abstract	Background: The objective is to assess cardiovascular (CV), malignancy, infectious, graft outcomes and tacrolimus levels for the Indigenous patients compared to Whites after kidney transplant (KTx). Methods: 165 Indigenous and 165 White patients matched for the KTx year at Mayo Clinic Arizona from 2007-2015 were studied over a median follow-up of 3 years. Propensity score was calculated to account for baseline differences. Results: Compared to Whites, Indigenous patients had the following characteristics: younger age, more obesity, diabetes, hypertension, and required dialysis prior to KTx (p<0.01). Indigenous patients had longer hospital stay for KTx, shorter follow-up and lived further from the transplant center (p<0.05). 210 (63.6%) received deceased donor KTx and more Whites received a living donor KTx compared to Indigenous patients (55.2% vs 17.6%, p<0.0001). Post-KTx, there was no difference in the CV event rates. The cumulative incidence of infectious complications was higher among the Indigenous patients (HR 1.81, p = 0.0005, 48.5% vs 38.2%, p = 0.013), with urinary causes as the most common. Malignancy rates were increased among Whites (13.3% vs 3.0%, p = 0.001) with skin cancer being the most common. There was a significant increase in the dose normalized tacrolimus level for the Indigenous patients compared to Whites at 1 months, 3 months, and 1 year post-KTx. After adjustment for the propensity score, there was no statistical difference in infectious or graft outcomes between the two groups but the mean number of emergency room visits and hospitalizations after KTx was significantly higher for Whites compared to Indigenous patients. Conclusions: Compared to Whites, Indigenous patients have similar CV events, graft outcomes and infectious complications after accounting for baseline differences.
MeSH term(s)	Adult ; Aged ; American Natives ; European Continental Ancestry Group ; Female ; Follow-Up Studies ; Graft Rejection/epidemiology ; Graft Rejection/prevention & control ; Graft Survival ; Humans ; Immunosuppressive Agents/therapeutic use ; Incidence ; Kidney Failure, Chronic/surgery ; Kidney Transplantation ; Male ; Middle Aged ; Propensity Score ; Retrospective Studies ; Treatment Outcome ; United States
Chemical Substances	Immunosuppressive Agents
Language	English
Publishing date	2021-02-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0244492
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Article ; Online: Direct Correlation of Soluble HLA and HLA-Containing Exosomes and Inverse Correlation of Tolerance Marker-Containing Exosomes With Antibody-Mediated Rejection After Simultaneous Liver-Kidney Transplantation: A Case Study.

Me, Hay Me / Ravichandran, Ranjithkumar / Khamash, Hasan A / Nair, Sumi S / Hacke, Katrin / Ramon, Daniel S / Mohanakumar, T / Heilman, Raymond L / Jaramillo, Andrés

Transplantation proceedings

2022

Abstract: There is a lower incidence of antibody-mediated rejection (AMR) after simultaneous liver-kidney transplantation (SLKT) than after kidney-only transplantation. It has been suggested that soluble human leukocyte antigen (sHLA) produced by the liver ... ...

Abstract	There is a lower incidence of antibody-mediated rejection (AMR) after simultaneous liver-kidney transplantation (SLKT) than after kidney-only transplantation. It has been suggested that soluble human leukocyte antigen (sHLA) produced by the liver protects the kidney from AMR. However, this hypothesis has not been tested after SLKT. We present a case of SLKT with 2 donor-specific antibodies (DSAs) (DR53, 12,364 mean fluorescence intensity [MFI]; DQ7, 1253 MFI) that displayed a decrease by day 7 (DR53, 2747 MFI; DQ7, 107 MFI). On day 351, the patient was diagnosed with kidney AMR associated with high levels of DSA (DR53, 18,542 MFI; DQ7, 22,007 MFI) that persisted until day 531. High levels of sHLA-DR/DQ and HLA-DR/DQ-containing exosomes were also detected on day 398. Consequently, the patient underwent treatment with plasmapheresis, intravenous immunoglobulin, prednisone, and rituximab. On day 752, biopsy results were negative for AMR. Moderate levels of DSA (DR53, 9798 MFI; DQ7, 1271 MFI), and baseline levels of sHLA-DR/DQ and HLA-DR/DQ-containing exosomes were observed. Increases in CD4
Language	English
Publishing date	2022-11-11
Publishing country	United States
Document type	Case Reports
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2022.10.025
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Zs.A 835: Show issues

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Article ; Online: Outcomes of dual kidney transplants from high KDPI kidneys are superior compared to single kidney high KDPI transplants at 1 year.

Das, Devika / Wagler, Josiah / Ohara, Stephanie / Nguyen, Michelle / Frasco, Peter E / Smith, Maxwell / Khamash, Hasan / Mathur, Amit K / Budhiraja, Pooja / Reddy, Kunam / Heilman, Raymond / Jadlowiec, Caroline

Clinical transplantation

2022 Volume 36, Issue 8, Page(s) e14737

Abstract: Dual kidney transplantation (DKT), utilizing two adult kidneys from the same donor for one recipient, has been used as a way to expand the available donor pool. These kidneys often come from high Kidney Donor Profile Index donors (KDPI > 85%). Data ... ...

Abstract	Dual kidney transplantation (DKT), utilizing two adult kidneys from the same donor for one recipient, has been used as a way to expand the available donor pool. These kidneys often come from high Kidney Donor Profile Index donors (KDPI > 85%). Data comparing outcomes between high KDPI DKT and single kidney transplants (SKT) remain limited. We assessed outcomes of 336 high KDPI kidney transplants performed at our center; 11.0% (n = 37) were DKT. Recipients of DKT were older (P = .02) and donors had a higher KDPI score (median 96% vs. 91%, P < .0001). DKT operative time was higher compared to SKT (+1.4 hours, P < .0001). There were no differences in delayed graft function (54.1% vs. 51.5%, P = .77) and hospital length of stay (median 4.0 vs. 3.0 days, P = .21) between DKT and SKT. Grade I Clavien-Dindo complications occurred in 8.1% of DKT and 13.7% of SKT (P = .008). There were no grade IVa, IVb, or V complications in either group. DKT had more glomerulosclerosis (P = .04), interstitial fibrosis (P = .02), tubular atrophy (P = .01), and arterial thickening (P = .03) on 1-year protocol biopsies. Estimated glomerular filtration was higher for DKT at 1- (P = .004) and 2-years post-transplant (P = .01). There were no differences in patient (HR 1.3, 95% CI .5-3.3, P = .58) or graft (HR 1.1, 95% CI .5-2.3, P = .83) survival. Good outcomes can be achieved with DKT using high KDPI kidneys with moderate chronic changes. DKT is a good option to help further utilize high KDPI kidneys and minimize discard.
MeSH term(s)	Adult ; Graft Survival ; Humans ; Kidney/pathology ; Kidney/surgery ; Kidney Diseases/pathology ; Kidney Transplantation ; Retrospective Studies ; Solitary Kidney/pathology ; Tissue Donors ; Transplants
Language	English
Publishing date	2022-06-05
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	639001-8
ISSN	1399-0012 ; 0902-0063
ISSN (online)	1399-0012
ISSN	0902-0063
DOI	10.1111/ctr.14737
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Article ; Online: Impact of Pregnancy on GFR Decline and Kidney Histology in Kidney Transplant Recipients.

Kattah, Andrea G / Albadri, Sam / Alexander, Mariam P / Smith, Byron / Parashuram, Santosh / Mai, Marin L / Khamash, Hasan A / Cosio, Fernando G / Garovic, Vesna D

Kidney international reports

2021 Volume 7, Issue 1, Page(s) 28–35

Abstract: Introduction: Women with advanced kidney disease are advised to wait until after transplant to pursue pregnancy, but the impact of pregnancy on estimated glomerular filtration rate (eGFR) decline and kidney histology is unclear.: Methods: We ... ...

Abstract	Introduction: Women with advanced kidney disease are advised to wait until after transplant to pursue pregnancy, but the impact of pregnancy on estimated glomerular filtration rate (eGFR) decline and kidney histology is unclear. Methods: We identified a cohort of women aged 18 to 44 years at transplant from 1996 to 2014 at our 3-site program ( Results: There were 37 women with one or more pregnancies lasting longer than 20 weeks gestation post-transplant. Comparing women with and without pregnancy post-transplant, there was a significant increase in the rate of eGFR decline after pregnancy (-2.4 ml/min per 1.73 m Conclusion: Pregnancy affects the rate of eGFR decline in the allograft. Postpregnancy biopsy findings revealed an increase in vascular injury, which could be a potential mechanism. We did not find a significant increase in risk of graft failure or reduction in eGFR by 50% owing to pregnancy.
Language	English
Publishing date	2021-10-30
Publishing country	United States
Document type	Journal Article
ISSN	2468-0249
ISSN (online)	2468-0249
DOI	10.1016/j.ekir.2021.10.010
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Article ; Online: Managing highly sensitized renal transplant candidates in the era of kidney paired donation and the new kidney allocation system: Is there still a role for desensitization?

Schinstock, Carrie A / Smith, Byron H / Montgomery, Robert A / Jordan, Stanley C / Bentall, Andrew J / Mai, Martin / Khamash, Hasan A / Stegall, Mark D

Clinical transplantation

2019 Volume 33, Issue 12, Page(s) e13751

Abstract: Kidney paired donation (KPD) and the new kidney allocation system (KAS) in the United States have led to improved transplantation rates for highly sensitized candidates. We aimed to assess the potential need for other approaches to improve the ... ...

Abstract	Kidney paired donation (KPD) and the new kidney allocation system (KAS) in the United States have led to improved transplantation rates for highly sensitized candidates. We aimed to assess the potential need for other approaches to improve the transplantation rate of highly sensitized candidates such as desensitization. Using the UNOS STAR file, we analyzed transplant rates in a prevalent active waiting-list cohort as of June 1, 2016, followed for 1 year. The overall transplantation rate was 18.9% (11 129/58769). However, only 9.7% (213/2204) of candidates with a calculated panel reactive antibody ≥99.9% received a transplant, and highly sensitized candidates were less likely to receive a living donor transplant. Among candidates with a CPRA ≥ 99.5% (ie. 100%), only 2.5% of transplants were from living donors (13 total, 7 from KPD). Nearly 4 years after KAS (6/30/2018), 1791 actively wait-listed candidates had a CPRA of ≥99.9% and 34.6% (620/1791) of these had ≥5 years of waiting time. Thus, despite KPD and KAS, many sensitized candidates have not been transplanted even with prolonged waiting time. We conclude that candidates with a CPRA ≥ 99.9% and sensitized candidates with an incompatible living donor and prolonged waiting time may benefit from desensitization to improve their ability to receive a transplant.
MeSH term(s)	Adult ; Desensitization, Immunologic/methods ; Donor Selection/methods ; Female ; Follow-Up Studies ; HLA Antigens/immunology ; Histocompatibility Testing ; Humans ; Kidney Failure, Chronic/immunology ; Kidney Failure, Chronic/surgery ; Kidney Transplantation/methods ; Living Donors/supply & distribution ; Male ; Middle Aged ; Resource Allocation/methods ; Retrospective Studies ; Tissue and Organ Procurement/methods ; Transplant Recipients ; United States
Chemical Substances	HLA Antigens
Language	English
Publishing date	2019-11-26
Publishing country	Denmark
Document type	Journal Article ; Observational Study ; Research Support, N.I.H., Extramural
ZDB-ID	639001-8
ISSN	1399-0012 ; 0902-0063
ISSN (online)	1399-0012
ISSN	0902-0063
DOI	10.1111/ctr.13751
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