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A Substantial Increase in Reporting of HLA-DPB Typing of Deceased Donors in US.

2014; Wolters Kluwer; Volume: 98; Linguagem: Inglês

10.1097/00007890-201407151-01991

1534-6080

Anna Y. Kucheryavaya, Dolly B. Tyan, G. Boyle, David F. Kiger, Cathi Murphey, L.A. Baxter-Lowe,

Renal Transplantation Outcomes and Treatments

Purpose: While the impact of HLA-DPB antibodies is controversial, many centers are considering these antibodies in patient management. Since the OPTN does not currently collect the DPB antibodies data for candidates, trends in DPB typing of deceased donors (DD) can be used as a surrogate marker for donation service areas (DSAs) with centers that are considering DPB antibodies. Methods: DPB antigens are collected on donor and recipient histo forms generated after the transplant, but testing is not required. % of donors typed for DPB by donor lab was computed by year for all HLA typed DD recovered in 2005-2013 (68,005 (97%) of all DD). In addition, 2013 data were compared to 2012 by location. For 2013, all analyses are based on Jan-Sept data. Results are based on data reported to the OPTN and may be an underestimate. Results: Fig 1 illustrates a substantial increase in the % of reporting of DPB typed DD from 0.1% in 2005 to 29% 2013. 62% of DSAs and 51% of labs had DPB typed DD in 2013, compared to 55% and 38% in 2012, respectively. In 2013, 11 labs (13%) reported DPB typing for 50%-79% of their donors, 6 (7%) reported it for 80-94% and 10 (12%) labs reported it for 95-100% of donors, compared to 5 (5%), 5 (5%) and 5 (5%) in 2012, respectively.Figure: No Caption available.For DD not DPB typed by donor labs, recipient labs subsequently DPB typed DD for some recipients (10% in 2013 vs 6% in 2012), likely due to patient's antibodies. Data from 3 large centers (>6200 patients combined) shows that the % of patients with DPB antibodies varied from 5 to 34% per center depending on the MFI cutoff level. Conclusion: Reporting of DPB antigens substantially increased in recent years suggesting growing recognition of DPB antibodies role in transplantation. Addition of DPB fields to DonorNet® could lead to increasing organ allocation efficiency by improving virtual crossmatch for candidates with DPB antibodies.