Quantifying the Risk of Incompatible Kidney Transplantation: A Multicenter Study
Identifieur interne : 005050 ( Main/Exploration ); précédent : 005049; suivant : 005051Quantifying the Risk of Incompatible Kidney Transplantation: A Multicenter Study
Auteurs : B. J. Orandi [États-Unis] ; J. M. Garonzik-Wang [États-Unis] ; A. B. Massie [États-Unis] ; A. A. Zachary [États-Unis] ; J. R. Montgomery [États-Unis] ; K. J. Van Arendonk [États-Unis] ; M. D. Stegall [États-Unis] ; S. C. Jordan [États-Unis] ; J. Oberholzer [États-Unis] ; T. B. Dunn [États-Unis] ; L. E. Ratner [États-Unis] ; S. Kapur [États-Unis] ; R. P. Pelletier [États-Unis] ; J. P. Roberts [États-Unis] ; M. L. Melcher [États-Unis] ; P. Singh [États-Unis] ; D. L. Sudan [États-Unis] ; M. P. Posner [États-Unis] ; J. M. El-Amm [États-Unis] ; R. Shapiro [États-Unis] ; M. Cooper [États-Unis] ; G. S. Lipkowitz [États-Unis] ; M. A. Rees [États-Unis] ; C. L. Marsh [États-Unis] ; B. R. Sankari [États-Unis] ; D. A. Gerber [États-Unis] ; P. W. Nelson [États-Unis] ; J. Wellen [États-Unis] ; A. Bozorgzadeh [États-Unis] ; A. O. Gaber [États-Unis] ; R. A. Montgomery [États-Unis] ; D. L. Segev [États-Unis]Source :
- American journal of transplantation : (Print) [ 1600-6135 ] ; 2014.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Analyse quantitative, Incompatibilité.
English descriptors
- KwdEn :
Abstract
Incompatible live donor kidney transplantation (ILDKT) offers a survival advantage over dialysis to patients with anti-HLA donor-specific antibody (DSA). Program-specific reports (PSRs) fail to account for ILDKT, placing this practice at regulatory risk. We collected DSA data, categorized as positive Luminex, negative flow crossmatch (PLNF) (n = 185), positive flow, negative cytotoxic crossmatch (PFNC) (n = 536) or positive cytotoxic crossmatch (PCC) (n = 304), from 22 centers. We tested associations between DSA, graft loss and mortality after adjusting for PSR model factors, using 9669 compatible patients as a comparison. PLNF patients had similar graft loss; however, PFNC (adjusted hazard ratio [aHR] = 1.64, 95% confidence interval [CI]: 1.15-2.23, p = 0.007) and PCC (aHR = 5.01, 95% CI: 3.71-6.77, p < 0.001) were associated with increased graft loss in the first year. PLNF patients had similar mortality; however, PFNC (aHR = 2.04; 95% CI: 1.28-3.26; p = 0.003) and PCC (aHR = 4.59; 95% CI: 2.98-7.07; p < 0.001) were associated with increased mortality. We simulated Centers for Medicare & Medicaid Services flagging to examine ILDKT's effect on the risk of being flagged. Compared to equal-quality centers performing no ILDKT, centers performing 5%, 10% or 20% PFNC had a 1.19-, 1.33- and 1.73-fold higher odds of being flagged. Centers performing 5%, 10% or 20% PCC had a 2.22-, 4.09- and 10.72-fold higher odds. Failure to account for ILDKT's increased risk places centers providing this life-saving treatment in jeopardy of regulatory intervention.
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Van Arendonk</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Surgery and Medicine, Johns Hopkins Hospital</s1><s2>Baltimore, MD</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Baltimore, MD</wicri:noRegion></affiliation></author><author><name sortKey="Stegall, M D" sort="Stegall, M D" uniqKey="Stegall M" first="M. D." last="Stegall">M. D. Stegall</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Surgery, Mayo Clinic</s1><s2>Rochester, MN</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Rochester, MN</wicri:noRegion></affiliation></author><author><name sortKey="Jordan, S C" sort="Jordan, S C" uniqKey="Jordan S" first="S. C." last="Jordan">S. C. Jordan</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Surgery, Cedars-Sinai Comprehensive Transplant Center</s1><s2>Los Angeles, CA</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Los Angeles, CA</wicri:noRegion></affiliation></author><author><name sortKey="Oberholzer, J" sort="Oberholzer, J" uniqKey="Oberholzer J" first="J." last="Oberholzer">J. Oberholzer</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Surgery, University of Illinois-Chicago</s1><s2>Chicago, IL</s2><s3>USA</s3><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Chicago, IL</wicri:noRegion></affiliation></author><author><name sortKey="Dunn, T B" sort="Dunn, T B" uniqKey="Dunn T" first="T. B." last="Dunn">T. B. Dunn</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Surgery, University of Minnesota</s1><s2>Minneapolis, MN</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Minneapolis, MN</wicri:noRegion></affiliation></author><author><name sortKey="Ratner, L E" sort="Ratner, L E" uniqKey="Ratner L" first="L. E." last="Ratner">L. E. Ratner</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Department of Surgery, Columbia University Medical Center</s1><s2>New York, NY</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>New York, NY</wicri:noRegion></affiliation></author><author><name sortKey="Kapur, S" sort="Kapur, S" uniqKey="Kapur S" first="S." last="Kapur">S. Kapur</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Department of Surgery, New York Presbyterian/Weill Cornell Medical Center</s1><s2>New York, NY</s2><s3>USA</s3><sZ>12 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>New York, NY</wicri:noRegion></affiliation></author><author><name sortKey="Pelletier, R P" sort="Pelletier, R P" uniqKey="Pelletier R" first="R. P." last="Pelletier">R. P. Pelletier</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Department of Surgery, The Ohio State University</s1><s2>Columbus, OH</s2><s3>USA</s3><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Columbus, OH</wicri:noRegion></affiliation></author><author><name sortKey="Roberts, J P" sort="Roberts, J P" uniqKey="Roberts J" first="J. P." last="Roberts">J. P. Roberts</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Department of Surgery, University of California-San Francisco</s1><s2>San Francisco, CA</s2><s3>USA</s3><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>San Francisco, CA</wicri:noRegion></affiliation></author><author><name sortKey="Melcher, M L" sort="Melcher, M L" uniqKey="Melcher M" first="M. L." last="Melcher">M. L. Melcher</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Department of Surgery, Stanford University</s1><s2>Palo Alto, CA</s2><s3>USA</s3><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Palo Alto, CA</wicri:noRegion></affiliation></author><author><name sortKey="Singh, P" sort="Singh, P" uniqKey="Singh P" first="P." last="Singh">P. Singh</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Department of Medicine, Thomas Jefferson University Hospital</s1><s2>Philadelphia, PA</s2><s3>USA</s3><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Philadelphia, PA</wicri:noRegion></affiliation></author><author><name sortKey="Sudan, D L" sort="Sudan, D L" uniqKey="Sudan D" first="D. L." last="Sudan">D. L. Sudan</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Department of Surgery, Duke University Medical Center</s1><s2>Durham, NC</s2><s3>USA</s3><sZ>17 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Durham, NC</wicri:noRegion></affiliation></author><author><name sortKey="Posner, M P" sort="Posner, M P" uniqKey="Posner M" first="M. P." last="Posner">M. P. Posner</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Department of Surgery, Virginia Commonwealth University</s1><s2>Richmond, VA</s2><s3>USA</s3><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Richmond, VA</wicri:noRegion></affiliation></author><author><name sortKey="El Amm, J M" sort="El Amm, J M" uniqKey="El Amm J" first="J. M." last="El-Amm">J. M. El-Amm</name><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Integris Baptist Medical Center, Transplant Division</s1><s2>Oklahoma City, OK</s2><s3>USA</s3><sZ>19 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Oklahoma City, OK</wicri:noRegion></affiliation></author><author><name sortKey="Shapiro, R" sort="Shapiro, R" uniqKey="Shapiro R" first="R." last="Shapiro">R. Shapiro</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Department of Surgery, University of Pittsburgh Medical Center</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>20 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Pittsburgh, PA</wicri:noRegion></affiliation></author><author><name sortKey="Cooper, M" sort="Cooper, M" uniqKey="Cooper M" first="M." last="Cooper">M. Cooper</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>Medstar Georgetown Transplant Institute</s1><s2>Washington, DC</s2><s3>USA</s3><sZ>21 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Medstar Georgetown Transplant Institute</wicri:noRegion></affiliation></author><author><name sortKey="Lipkowitz, G S" sort="Lipkowitz, G S" uniqKey="Lipkowitz G" first="G. S." last="Lipkowitz">G. S. Lipkowitz</name><affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Department of Surgery, Baystate Medical Center</s1><s2>Springfield, MA</s2><s3>USA</s3><sZ>22 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Springfield, MA</wicri:noRegion></affiliation></author><author><name sortKey="Rees, M A" sort="Rees, M A" uniqKey="Rees M" first="M. A." last="Rees">M. A. Rees</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Department of Urology, University of Toledo Medical Center</s1><s2>Toledo, OH</s2><s3>USA</s3><sZ>23 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Toledo, OH</wicri:noRegion></affiliation></author><author><name sortKey="Marsh, C L" sort="Marsh, C L" uniqKey="Marsh C" first="C. L." last="Marsh">C. L. Marsh</name><affiliation wicri:level="1"><inist:fA14 i1="19"><s1>Department of Surgery, Scripps Clinic and Green Hospital</s1><s2>La Jolla, CA</s2><s3>USA</s3><sZ>24 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>La Jolla, CA</wicri:noRegion></affiliation></author><author><name sortKey="Sankari, B R" sort="Sankari, B R" uniqKey="Sankari B" first="B. R." last="Sankari">B. R. Sankari</name><affiliation wicri:level="1"><inist:fA14 i1="20"><s1>Department of Urology, St. Vincent Hospital</s1><s2>Worcester, MA</s2><s3>USA</s3><sZ>25 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Worcester, MA</wicri:noRegion></affiliation></author><author><name sortKey="Gerber, D A" sort="Gerber, D A" uniqKey="Gerber D" first="D. A." last="Gerber">D. A. Gerber</name><affiliation wicri:level="1"><inist:fA14 i1="21"><s1>Department of Surgery, University of North Carolina School of Medicine</s1><s2>Chapel Hill, NC</s2><s3>USA</s3><sZ>26 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Chapel Hill, NC</wicri:noRegion></affiliation></author><author><name sortKey="Nelson, P W" sort="Nelson, P W" uniqKey="Nelson P" first="P. W." last="Nelson">P. W. Nelson</name><affiliation wicri:level="1"><inist:fA14 i1="22"><s1>Department of Surgery, St. Vincent Hospital</s1><s2>Indianapolis, IN</s2><s3>USA</s3><sZ>27 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Indianapolis, IN</wicri:noRegion></affiliation></author><author><name sortKey="Wellen, J" sort="Wellen, J" uniqKey="Wellen J" first="J." last="Wellen">J. Wellen</name><affiliation wicri:level="1"><inist:fA14 i1="23"><s1>Department of Surgery, Barnes-Jewish Hospital</s1><s2>St. Louis, MO</s2><s3>USA</s3><sZ>28 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>St. Louis, MO</wicri:noRegion></affiliation></author><author><name sortKey="Bozorgzadeh, A" sort="Bozorgzadeh, A" uniqKey="Bozorgzadeh A" first="A." last="Bozorgzadeh">A. Bozorgzadeh</name><affiliation wicri:level="1"><inist:fA14 i1="24"><s1>Department of Surgery, University of Massachusetts Memorial Medical Center</s1><s2>Worcester, MA</s2><s3>USA</s3><sZ>29 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Worcester, MA</wicri:noRegion></affiliation></author><author><name sortKey="Gaber, A O" sort="Gaber, A O" uniqKey="Gaber A" first="A. O." last="Gaber">A. O. Gaber</name><affiliation wicri:level="1"><inist:fA14 i1="25"><s1>Department of Surgery, Houston Methodist Hospital</s1><s2>Houston, TX</s2><s3>USA</s3><sZ>30 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Houston, TX</wicri:noRegion></affiliation></author><author><name sortKey="Montgomery, R A" sort="Montgomery, R A" uniqKey="Montgomery R" first="R. A." last="Montgomery">R. A. Montgomery</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Surgery and Medicine, Johns Hopkins Hospital</s1><s2>Baltimore, MD</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Baltimore, MD</wicri:noRegion></affiliation></author><author><name sortKey="Segev, D L" sort="Segev, D L" uniqKey="Segev D" first="D. L." last="Segev">D. L. Segev</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Surgery and Medicine, Johns Hopkins Hospital</s1><s2>Baltimore, MD</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Baltimore, MD</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">14-0194972</idno><date when="2014">2014</date><idno type="stanalyst">PASCAL 14-0194972 INIST</idno><idno type="RBID">Pascal:14-0194972</idno><idno type="wicri:Area/PascalFrancis/Corpus">000779</idno><idno type="wicri:Area/PascalFrancis/Curation">003E53</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000391</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000391</idno><idno type="wicri:doubleKey">1600-6135:2014:Orandi B:quantifying:the:risk</idno><idno type="wicri:Area/Main/Merge">005314</idno><idno type="wicri:Area/Main/Curation">005050</idno><idno type="wicri:Area/Main/Exploration">005050</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Quantifying the Risk of Incompatible Kidney Transplantation: A Multicenter Study</title><author><name sortKey="Orandi, B J" sort="Orandi, B J" uniqKey="Orandi B" first="B. J." last="Orandi">B. J. Orandi</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Surgery and Medicine, Johns Hopkins Hospital</s1><s2>Baltimore, MD</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Baltimore, MD</wicri:noRegion></affiliation></author><author><name sortKey="Garonzik Wang, J M" sort="Garonzik Wang, J M" uniqKey="Garonzik Wang J" first="J. M." last="Garonzik-Wang">J. M. Garonzik-Wang</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Surgery and Medicine, Johns Hopkins Hospital</s1><s2>Baltimore, MD</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Baltimore, MD</wicri:noRegion></affiliation></author><author><name sortKey="Massie, A B" sort="Massie, A B" uniqKey="Massie A" first="A. B." last="Massie">A. B. Massie</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Surgery and Medicine, Johns Hopkins Hospital</s1><s2>Baltimore, MD</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Baltimore, MD</wicri:noRegion></affiliation></author><author><name sortKey="Zachary, A A" sort="Zachary, A A" uniqKey="Zachary A" first="A. A." last="Zachary">A. A. Zachary</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Surgery and Medicine, Johns Hopkins Hospital</s1><s2>Baltimore, MD</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Baltimore, MD</wicri:noRegion></affiliation></author><author><name sortKey="Montgomery, J R" sort="Montgomery, J R" uniqKey="Montgomery J" first="J. R." last="Montgomery">J. R. Montgomery</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Surgery and Medicine, Johns Hopkins Hospital</s1><s2>Baltimore, MD</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Baltimore, MD</wicri:noRegion></affiliation></author><author><name sortKey="Van Arendonk, K J" sort="Van Arendonk, K J" uniqKey="Van Arendonk K" first="K. J." last="Van Arendonk">K. J. Van Arendonk</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Surgery and Medicine, Johns Hopkins Hospital</s1><s2>Baltimore, MD</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Baltimore, MD</wicri:noRegion></affiliation></author><author><name sortKey="Stegall, M D" sort="Stegall, M D" uniqKey="Stegall M" first="M. D." last="Stegall">M. D. Stegall</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Surgery, Mayo Clinic</s1><s2>Rochester, MN</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Rochester, MN</wicri:noRegion></affiliation></author><author><name sortKey="Jordan, S C" sort="Jordan, S C" uniqKey="Jordan S" first="S. C." last="Jordan">S. C. Jordan</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Surgery, Cedars-Sinai Comprehensive Transplant Center</s1><s2>Los Angeles, CA</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Los Angeles, CA</wicri:noRegion></affiliation></author><author><name sortKey="Oberholzer, J" sort="Oberholzer, J" uniqKey="Oberholzer J" first="J." last="Oberholzer">J. Oberholzer</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Surgery, University of Illinois-Chicago</s1><s2>Chicago, IL</s2><s3>USA</s3><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Chicago, IL</wicri:noRegion></affiliation></author><author><name sortKey="Dunn, T B" sort="Dunn, T B" uniqKey="Dunn T" first="T. B." last="Dunn">T. B. Dunn</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Surgery, University of Minnesota</s1><s2>Minneapolis, MN</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Minneapolis, MN</wicri:noRegion></affiliation></author><author><name sortKey="Ratner, L E" sort="Ratner, L E" uniqKey="Ratner L" first="L. E." last="Ratner">L. E. Ratner</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Department of Surgery, Columbia University Medical Center</s1><s2>New York, NY</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>New York, NY</wicri:noRegion></affiliation></author><author><name sortKey="Kapur, S" sort="Kapur, S" uniqKey="Kapur S" first="S." last="Kapur">S. Kapur</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Department of Surgery, New York Presbyterian/Weill Cornell Medical Center</s1><s2>New York, NY</s2><s3>USA</s3><sZ>12 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>New York, NY</wicri:noRegion></affiliation></author><author><name sortKey="Pelletier, R P" sort="Pelletier, R P" uniqKey="Pelletier R" first="R. P." last="Pelletier">R. P. Pelletier</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Department of Surgery, The Ohio State University</s1><s2>Columbus, OH</s2><s3>USA</s3><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Columbus, OH</wicri:noRegion></affiliation></author><author><name sortKey="Roberts, J P" sort="Roberts, J P" uniqKey="Roberts J" first="J. P." last="Roberts">J. P. Roberts</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Department of Surgery, University of California-San Francisco</s1><s2>San Francisco, CA</s2><s3>USA</s3><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>San Francisco, CA</wicri:noRegion></affiliation></author><author><name sortKey="Melcher, M L" sort="Melcher, M L" uniqKey="Melcher M" first="M. L." last="Melcher">M. L. Melcher</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Department of Surgery, Stanford University</s1><s2>Palo Alto, CA</s2><s3>USA</s3><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Palo Alto, CA</wicri:noRegion></affiliation></author><author><name sortKey="Singh, P" sort="Singh, P" uniqKey="Singh P" first="P." last="Singh">P. Singh</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Department of Medicine, Thomas Jefferson University Hospital</s1><s2>Philadelphia, PA</s2><s3>USA</s3><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Philadelphia, PA</wicri:noRegion></affiliation></author><author><name sortKey="Sudan, D L" sort="Sudan, D L" uniqKey="Sudan D" first="D. L." last="Sudan">D. L. Sudan</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Department of Surgery, Duke University Medical Center</s1><s2>Durham, NC</s2><s3>USA</s3><sZ>17 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Durham, NC</wicri:noRegion></affiliation></author><author><name sortKey="Posner, M P" sort="Posner, M P" uniqKey="Posner M" first="M. P." last="Posner">M. P. Posner</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Department of Surgery, Virginia Commonwealth University</s1><s2>Richmond, VA</s2><s3>USA</s3><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Richmond, VA</wicri:noRegion></affiliation></author><author><name sortKey="El Amm, J M" sort="El Amm, J M" uniqKey="El Amm J" first="J. M." last="El-Amm">J. M. El-Amm</name><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Integris Baptist Medical Center, Transplant Division</s1><s2>Oklahoma City, OK</s2><s3>USA</s3><sZ>19 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Oklahoma City, OK</wicri:noRegion></affiliation></author><author><name sortKey="Shapiro, R" sort="Shapiro, R" uniqKey="Shapiro R" first="R." last="Shapiro">R. Shapiro</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Department of Surgery, University of Pittsburgh Medical Center</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>20 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Pittsburgh, PA</wicri:noRegion></affiliation></author><author><name sortKey="Cooper, M" sort="Cooper, M" uniqKey="Cooper M" first="M." last="Cooper">M. Cooper</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>Medstar Georgetown Transplant Institute</s1><s2>Washington, DC</s2><s3>USA</s3><sZ>21 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Medstar Georgetown Transplant Institute</wicri:noRegion></affiliation></author><author><name sortKey="Lipkowitz, G S" sort="Lipkowitz, G S" uniqKey="Lipkowitz G" first="G. S." last="Lipkowitz">G. S. Lipkowitz</name><affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Department of Surgery, Baystate Medical Center</s1><s2>Springfield, MA</s2><s3>USA</s3><sZ>22 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Springfield, MA</wicri:noRegion></affiliation></author><author><name sortKey="Rees, M A" sort="Rees, M A" uniqKey="Rees M" first="M. A." last="Rees">M. A. Rees</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Department of Urology, University of Toledo Medical Center</s1><s2>Toledo, OH</s2><s3>USA</s3><sZ>23 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Toledo, OH</wicri:noRegion></affiliation></author><author><name sortKey="Marsh, C L" sort="Marsh, C L" uniqKey="Marsh C" first="C. L." last="Marsh">C. L. Marsh</name><affiliation wicri:level="1"><inist:fA14 i1="19"><s1>Department of Surgery, Scripps Clinic and Green Hospital</s1><s2>La Jolla, CA</s2><s3>USA</s3><sZ>24 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>La Jolla, CA</wicri:noRegion></affiliation></author><author><name sortKey="Sankari, B R" sort="Sankari, B R" uniqKey="Sankari B" first="B. R." last="Sankari">B. R. Sankari</name><affiliation wicri:level="1"><inist:fA14 i1="20"><s1>Department of Urology, St. Vincent Hospital</s1><s2>Worcester, MA</s2><s3>USA</s3><sZ>25 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Worcester, MA</wicri:noRegion></affiliation></author><author><name sortKey="Gerber, D A" sort="Gerber, D A" uniqKey="Gerber D" first="D. A." last="Gerber">D. A. Gerber</name><affiliation wicri:level="1"><inist:fA14 i1="21"><s1>Department of Surgery, University of North Carolina School of Medicine</s1><s2>Chapel Hill, NC</s2><s3>USA</s3><sZ>26 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Chapel Hill, NC</wicri:noRegion></affiliation></author><author><name sortKey="Nelson, P W" sort="Nelson, P W" uniqKey="Nelson P" first="P. W." last="Nelson">P. W. Nelson</name><affiliation wicri:level="1"><inist:fA14 i1="22"><s1>Department of Surgery, St. Vincent Hospital</s1><s2>Indianapolis, IN</s2><s3>USA</s3><sZ>27 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Indianapolis, IN</wicri:noRegion></affiliation></author><author><name sortKey="Wellen, J" sort="Wellen, J" uniqKey="Wellen J" first="J." last="Wellen">J. Wellen</name><affiliation wicri:level="1"><inist:fA14 i1="23"><s1>Department of Surgery, Barnes-Jewish Hospital</s1><s2>St. Louis, MO</s2><s3>USA</s3><sZ>28 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>St. Louis, MO</wicri:noRegion></affiliation></author><author><name sortKey="Bozorgzadeh, A" sort="Bozorgzadeh, A" uniqKey="Bozorgzadeh A" first="A." last="Bozorgzadeh">A. Bozorgzadeh</name><affiliation wicri:level="1"><inist:fA14 i1="24"><s1>Department of Surgery, University of Massachusetts Memorial Medical Center</s1><s2>Worcester, MA</s2><s3>USA</s3><sZ>29 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Worcester, MA</wicri:noRegion></affiliation></author><author><name sortKey="Gaber, A O" sort="Gaber, A O" uniqKey="Gaber A" first="A. O." last="Gaber">A. O. Gaber</name><affiliation wicri:level="1"><inist:fA14 i1="25"><s1>Department of Surgery, Houston Methodist Hospital</s1><s2>Houston, TX</s2><s3>USA</s3><sZ>30 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Houston, TX</wicri:noRegion></affiliation></author><author><name sortKey="Montgomery, R A" sort="Montgomery, R A" uniqKey="Montgomery R" first="R. A." last="Montgomery">R. A. Montgomery</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Surgery and Medicine, Johns Hopkins Hospital</s1><s2>Baltimore, MD</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Baltimore, MD</wicri:noRegion></affiliation></author><author><name sortKey="Segev, D L" sort="Segev, D L" uniqKey="Segev D" first="D. L." last="Segev">D. L. Segev</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Departments of Surgery and Medicine, Johns Hopkins Hospital</s1><s2>Baltimore, MD</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>31 aut.</sZ><sZ>32 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Baltimore, MD</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">American journal of transplantation : (Print)</title><title level="j" type="abbreviated">Am. j. transplant. : (Print)</title><idno type="ISSN">1600-6135</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">American journal of transplantation : (Print)</title><title level="j" type="abbreviated">Am. j. transplant. : (Print)</title><idno type="ISSN">1600-6135</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Homotransplantation</term><term>Incompatibility</term><term>Kidney</term><term>Kidney transplantation</term><term>Multicenter study</term><term>Quantitative analysis</term><term>Risk</term><term>Risk factor</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Transplantation rénale</term><term>Analyse quantitative</term><term>Facteur risque</term><term>Homotransplantation</term><term>Risque</term><term>Incompatibilité</term><term>Rein</term><term>Etude multicentrique</term><term>Traitement</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Analyse quantitative</term><term>Incompatibilité</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Incompatible live donor kidney transplantation (ILDKT) offers a survival advantage over dialysis to patients with anti-HLA donor-specific antibody (DSA). Program-specific reports (PSRs) fail to account for ILDKT, placing this practice at regulatory risk. We collected DSA data, categorized as positive Luminex, negative flow crossmatch (PLNF) (n = 185), positive flow, negative cytotoxic crossmatch (PFNC) (n = 536) or positive cytotoxic crossmatch (PCC) (n = 304), from 22 centers. We tested associations between DSA, graft loss and mortality after adjusting for PSR model factors, using 9669 compatible patients as a comparison. PLNF patients had similar graft loss; however, PFNC (adjusted hazard ratio [aHR] = 1.64, 95% confidence interval [CI]: 1.15-2.23, p = 0.007) and PCC (aHR = 5.01, 95% CI: 3.71-6.77, p < 0.001) were associated with increased graft loss in the first year. PLNF patients had similar mortality; however, PFNC (aHR = 2.04; 95% CI: 1.28-3.26; p = 0.003) and PCC (aHR = 4.59; 95% CI: 2.98-7.07; p < 0.001) were associated with increased mortality. We simulated Centers for Medicare & Medicaid Services flagging to examine ILDKT's effect on the risk of being flagged. Compared to equal-quality centers performing no ILDKT, centers performing 5%, 10% or 20% PFNC had a 1.19-, 1.33- and 1.73-fold higher odds of being flagged. Centers performing 5%, 10% or 20% PCC had a 2.22-, 4.09- and 10.72-fold higher odds. Failure to account for ILDKT's increased risk places centers providing this life-saving treatment in jeopardy of regulatory intervention.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country></list><tree><country name="États-Unis"><noRegion><name sortKey="Orandi, B J" sort="Orandi, B J" uniqKey="Orandi B" first="B. J." last="Orandi">B. J. Orandi</name></noRegion><name sortKey="Bozorgzadeh, A" sort="Bozorgzadeh, A" uniqKey="Bozorgzadeh A" first="A." last="Bozorgzadeh">A. Bozorgzadeh</name><name sortKey="Cooper, M" sort="Cooper, M" uniqKey="Cooper M" first="M." last="Cooper">M. Cooper</name><name sortKey="Dunn, T B" sort="Dunn, T B" uniqKey="Dunn T" first="T. B." last="Dunn">T. B. Dunn</name><name sortKey="El Amm, J M" sort="El Amm, J M" uniqKey="El Amm J" first="J. M." last="El-Amm">J. M. El-Amm</name><name sortKey="Gaber, A O" sort="Gaber, A O" uniqKey="Gaber A" first="A. O." last="Gaber">A. O. Gaber</name><name sortKey="Garonzik Wang, J M" sort="Garonzik Wang, J M" uniqKey="Garonzik Wang J" first="J. M." last="Garonzik-Wang">J. M. Garonzik-Wang</name><name sortKey="Gerber, D A" sort="Gerber, D A" uniqKey="Gerber D" first="D. A." last="Gerber">D. A. Gerber</name><name sortKey="Jordan, S C" sort="Jordan, S C" uniqKey="Jordan S" first="S. C." last="Jordan">S. C. Jordan</name><name sortKey="Kapur, S" sort="Kapur, S" uniqKey="Kapur S" first="S." last="Kapur">S. Kapur</name><name sortKey="Lipkowitz, G S" sort="Lipkowitz, G S" uniqKey="Lipkowitz G" first="G. S." last="Lipkowitz">G. S. Lipkowitz</name><name sortKey="Marsh, C L" sort="Marsh, C L" uniqKey="Marsh C" first="C. L." last="Marsh">C. L. Marsh</name><name sortKey="Massie, A B" sort="Massie, A B" uniqKey="Massie A" first="A. B." last="Massie">A. B. Massie</name><name sortKey="Melcher, M L" sort="Melcher, M L" uniqKey="Melcher M" first="M. L." last="Melcher">M. L. Melcher</name><name sortKey="Montgomery, J R" sort="Montgomery, J R" uniqKey="Montgomery J" first="J. R." last="Montgomery">J. R. Montgomery</name><name sortKey="Montgomery, R A" sort="Montgomery, R A" uniqKey="Montgomery R" first="R. A." last="Montgomery">R. A. Montgomery</name><name sortKey="Nelson, P W" sort="Nelson, P W" uniqKey="Nelson P" first="P. W." last="Nelson">P. W. Nelson</name><name sortKey="Oberholzer, J" sort="Oberholzer, J" uniqKey="Oberholzer J" first="J." last="Oberholzer">J. Oberholzer</name><name sortKey="Pelletier, R P" sort="Pelletier, R P" uniqKey="Pelletier R" first="R. P." last="Pelletier">R. P. Pelletier</name><name sortKey="Posner, M P" sort="Posner, M P" uniqKey="Posner M" first="M. P." last="Posner">M. P. Posner</name><name sortKey="Ratner, L E" sort="Ratner, L E" uniqKey="Ratner L" first="L. E." last="Ratner">L. E. Ratner</name><name sortKey="Rees, M A" sort="Rees, M A" uniqKey="Rees M" first="M. A." last="Rees">M. A. Rees</name><name sortKey="Roberts, J P" sort="Roberts, J P" uniqKey="Roberts J" first="J. P." last="Roberts">J. P. Roberts</name><name sortKey="Sankari, B R" sort="Sankari, B R" uniqKey="Sankari B" first="B. R." last="Sankari">B. R. Sankari</name><name sortKey="Segev, D L" sort="Segev, D L" uniqKey="Segev D" first="D. L." last="Segev">D. L. Segev</name><name sortKey="Shapiro, R" sort="Shapiro, R" uniqKey="Shapiro R" first="R." last="Shapiro">R. Shapiro</name><name sortKey="Singh, P" sort="Singh, P" uniqKey="Singh P" first="P." last="Singh">P. Singh</name><name sortKey="Stegall, M D" sort="Stegall, M D" uniqKey="Stegall M" first="M. D." last="Stegall">M. D. Stegall</name><name sortKey="Sudan, D L" sort="Sudan, D L" uniqKey="Sudan D" first="D. L." last="Sudan">D. L. Sudan</name><name sortKey="Van Arendonk, K J" sort="Van Arendonk, K J" uniqKey="Van Arendonk K" first="K. J." last="Van Arendonk">K. J. Van Arendonk</name><name sortKey="Wellen, J" sort="Wellen, J" uniqKey="Wellen J" first="J." last="Wellen">J. Wellen</name><name sortKey="Zachary, A A" sort="Zachary, A A" uniqKey="Zachary A" first="A. A." last="Zachary">A. A. Zachary</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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