Current status of the Scandiatransplant acceptable mismatch program

Area of Science:

• Nephrology
• Immunology
• Transplantation Science

Background:

• Highly immunized patients face challenges receiving kidney transplants due to antibody formation against human leukocyte antigens (HLA).
• The Scandiatransplant Acceptable Mismatch Program (STAMP) was established in 2009 to address this issue.

Purpose of the Study:

• To evaluate the effectiveness of the STAMP program in improving transplant outcomes for highly immunized kidney recipients.
• To assess the impact of STAMP on reducing waiting times for suitable deceased donor kidney grafts.

Main Methods:

• Utilized data from the Scandiatransplant database to analyze program outcomes over the initial 3 years.
• Tracked the number of transplantations performed and changes in mean waiting times for highly immunized patients.
• Incorporated transplantability calculations and expanded the HLA matching criteria (including HLA-C) over time.

Main Results:

• 31 out of 115 (27%) recipients in the STAMP program underwent transplantation within the first 3 years.
• The mean waiting time for highly immunized patients decreased from 42 months (2008) to 37 months (2011).
• Program enhancements, including transplantability calculations and HLA-C inclusion, were implemented to further optimize donor matching.

Conclusions:

• STAMP has demonstrated positive effects in facilitating kidney transplantation for highly immunized recipients.
• Continuous evaluation and program adjustments are crucial for ongoing improvement in transplant procedures and outcomes.
• Challenges remain in accurately identifying clinically relevant HLA antibodies for precise donor-recipient matching.