Abstract 17107: Virtual Crossmatch May Render Desensitization Therapy Obsolete in Status 1 Patients Awaiting Heart Transplant
Purpose: Sensitized patients (pts) awaiting heart transplant (HTx) are purported to have a longer waiting time because of a shrinking donor pool due to unacceptable antigens. The virtual crossmatch (VXM) has mostly eliminated the use of a prospective donor specific crossmatch and has expanded the donor pool. It has not been established whether the VXM has leveled the playing field to allow sensitized pts to have comparable waiting times (WT) to non-sensitized pts.
Methods: Between August 2008 and May 2012, we evaluated 118 status 1 pts awaiting HTx who were sensitized and non-sensitized. Pts were divided into groups with peak pre-transplant PRAs of <10%, 10-39%%, 40-69%, <70%. The percent of pts who received a HTx was recorded. WT for those who were transplanted were also recorded for pts in each group. All pts in the study did not receive desensitization therapy and VXM was utilized in all cases.
Results: Of the 118 status 1 patients, 111 were transplanted. There was no difference among the PRA <10%, PRA 10-39%, PRA 40-69%, and PRA <70% groups in the percent of pts who received a HTx (92% vs. 100% vs. 100% vs. 89%, p=NS). The median WT among each group was also comparable (see table). The large (BMI<30) and blood type O pts appeared to be similar in all groups (p=NS) and did not appear to affect the outcome.
Conclusions: VXM for sensitized pts appears to have obviated the need for desensitization therapy in status 1 pts. A randomized trial is warranted.
Author Disclosures: C.T. Vanichsam: None. N. Reinsmoen: None. F. Liou: None. Z. Yu: None. J. Yabuno: None. J. Patel: Research Grant; Modest; Alexion Pharmaceuticals. M. Kittleson: None. M. Hamilton: None. D. Chang: Other; Modest; Abbott Pharmaceuticals. L. Czer: None. J. Kobashigawa: Research Grant; Modest; Xdx, Inc., Novartis Pharmaceuticals, Transmedics, Inc..
- © 2014 by American Heart Association, Inc.