Monday, September 27, 2010 2:00 PM - American Society for ...

Conclusions: These results demonstrate that, despite markedly improved sensitivity, the use of solid phasemethods to identify HLA-specific antibodies may provide apparently aberrant results that require carefulclinical and laboratory investigation.53-PTHE IMPACT OF ALLOSENSITIZATION ON TIME TO TRANSPLANTATION ANDMORTALITY IN A COHORT OF PATIENTS AWAITING LUNG TRANSPLANTATION.Joseph T. Weber 1 , Bryan F. Meyers 2 , Alexander Patterson 2 , Elbert P. Trulock 1 , ThalachallourMohanakumar 3 , Ramsey Hachem 1 . 1 Division of Pulmonary & Critical Care Medicine, WashingtonUniversity School of Medicine, Saint Louis, MO, USA; 2 Division of Cardiothoracic Surgery, WashingtonUniversity School of Medicine, Saint Louis, MO, USA; 3 Department of Surgery, Washington UniversitySchool of Medicine, Saint Louis, MO, USA.Aim: To determine if allosensitization has an impact on the rate of transplantation, waiting time, or wait listmortality in those awaiting lung transplantation.Methods: We performed a retrospective cohort study of 64 consecutive candidates who were active on thewaiting list at our program between 01/2006 and 07/2007. Patients were prospectively screened forpreformed anti-HLA antibodies using the LABScreen Single Antigen assay at the time of listing. Acalculated Panel Reactive Antibody (cPRA) was obtained using the UNOS calculator for each candidate.We analyzed time to event using the Kaplan-Meier and Cox regression methods.Results: Of the 64 candidates, 22 (34%) were sensitized and 17 (26%) had a cPRA>50%. Sensitizedcandidates were significantly less likely to undergo transplantation using the virtual crossmatch approach(log rank p=0.0006).[figure1]In a multivariate Cox regression analysis, cPRA>50% was a significantnegative predictor of transplantation (OR=0.28; 95%CI: 0.1-0.6, p=0.001). Additionally, 4 of the 42 (10%)non-sensitized patients died while on the waiting list compared to 5 of the 22 (23%) sensitized patients (p =0.004). All 5 sensitized patients who died on the waiting list had a cPRA>50% while none of the sensitizedpatients with a cPRA