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Kidney Week

Abstract: PO2519

Does the Timing of Dialysis Initiation Affect Peak Calculated Panel Reactive Antibody in Waitlisted Kidney Transplant Candidates?

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Price, Adam, Medical University of South Carolina, Charleston, South Carolina, United States
  • Mohamed Ahmed, Mohamed A o, Medical University of South Carolina, Charleston, South Carolina, United States
  • Su, Zemin, Medical University of South Carolina, Charleston, South Carolina, United States
  • Posadas, Maria Aurora C., Medical University of South Carolina, Charleston, South Carolina, United States
  • Soliman, Karim Magdy, Medical University of South Carolina, Charleston, South Carolina, United States
  • Rao, Vinaya, Medical University of South Carolina, Charleston, South Carolina, United States
  • Casey, Michael, Medical University of South Carolina, Charleston, South Carolina, United States
Background

Higher calculated panel reactive antibody (cPRA) restricts access to kidney transplantation, but it’s unclear how the timing of dialysis initiation after listing might affect cPRA. We hypothesized that patients with earlier dialysis initiation would have higher cPRA scores.

Methods

This was a retrospective SRTR database study of adults listed for a solitary kidney transplant from 10/1/09 to 11/30/18. Waitlisted patients were stratified by dialysis initiation: prelist, 0-1 year after listing, 1-2 years after listing, or no dialysis within 2 years after listing. The outcomes studied were mean peak CPRA at 0-1 year and 0-2 years after listing. One-way ANOVA was used for statistical analysis.

Results

A total of 173,964 patients were identified who were waitlisted for 1-2 years. With later dialysis initiation, there was a stepwise decline in mean peak CPRA between those who initiated dialysis prelist, 0-1 year after listing, and 1-2 years after listing (Figure 1). There was no difference in mean peak CPRA between the dialysis initiation groups “1-2 years after listing” and “no dialysis 2 years after listing.” A similar stepwise decline in mean peak CPRA was seen with patients who were waitlisted for 0-1 year (Table 1).

Conclusion

Our data suggest that waitlisted patients with earlier dialysis initiation may be at risk for developing higher cPRA scores. If verified with further studies, then this may be an incentive for early predialysis referrals for transplant evaluation.

Graph 1: Mean Peak cPRA by Dialysis Initiation Time Among 1-2 Years Waitlisted Patients

Tabel 1: Mean Peak cPRA Data

Funding

  • Commercial Support