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Keywords:

  • Access to transplantation;
  • anti-HLA antibodies;
  • crossmatching;
  • donor-specific antibodies;
  • histocompatibility;
  • PRA

The ways we measure whether a patient is sensitized to HLA antigens and to what extent sensitization affects access to transplantation have changed remarkably during the past decade. What we mean by sensitized and broadly sensitized today is heavily dependent upon the sensitivity of the test that is used to measure antibodies. Because we provide additional allocation points for broadly sensitized patients in the United States kidney allocation system in an effort to compensate for their biological disadvantage, some consistency and accountability are required. The calculated panel-reactive antibody, which provides an estimate of the percentage of deceased organ donors that will be crossmatch incompatible for a candidate provides both consistency and accountability.