ArticleLancet (London, England)2017
Post-listing survival for highly sensitised patients on the UK kidney transplant waiting list: a matched cohort analysis.
Article in Lancet (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 49 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
49 citing papers in PubMed, 1 synthesis or guideline pooled it.
- European Guideline for the Management of Kidney Transplant Patients With HLA Antibodies: By the European Society for Organ Transplantation Working Group.Transplant international : official journal of the European Society for Organ Transplantation · 2022Guideline
- Safety and efficacy of eculizumab in the prevention of antibody-mediated rejection in living-donor kidney transplant recipients requiring desensitization therapy: A randomized trial.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2019Trial
- Graft survival and rejection with repeated human leukocyte antigen (HLA) mismatch in kidney transplantation: a retrospective multicentre cohort study protocol.BMC nephrology · 2026Article
- Sensitization and Deceased-Donor Kidney Transplant Access in France.Kidney international reports · 2026Article
- Retrospective cohort study of epitope-based virtual crossmatch allocation in a public transplant system (Pernambuco, Brazil).Frontiers in immunology · 2026Article
- Reshaping the landscape of HLA desensitization through immune engineering.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- Soft kidney allocation improves HLA matching and maintains allocation order.Communications medicine · 2025Article
- Desensitization in HLA-incompatible kidney transplant recipients: current strategies and emerging perspectives.Clinical kidney journal · 2025Review
- Comparison of outcomes after living and deceased donor kidney transplantation: UK national cohort study.The British journal of surgery · 2025Article
- A novel method to predict the haemoglobin concentration after kidney transplantation based on machine learning: prediction model establishment and method optimization.BMC medical informatics and decision making · 2025Article
- Life beyond antibodies: quality of life after desensitization in kidney transplantation.Clinical kidney journal · 2025Article
- Use of HLA desensitization in the management of renal transplant recipients in Europe.Frontiers in immunology · 2025Article
- Skewed pretransplant lymphocytes subpopulations correlate with opportunistic infection onset within the first two years following kidney transplantation.Frontiers in immunology · 2025Article
- Optimizing HLA desensitization: serum dilution strategies and platform-specific MFI thresholds for antibody-mediated rejection risk in kidney transplantation.Frontiers in immunology · 2025Article
- Kidney transplant outcomes in HLA desensitized patients with pretransplant CDC and/or FCM positive crossmatches.Frontiers in immunology · 2025Article
- Open-Label Phase 1/2 Study of Daratumumab-Based Desensitization Before Kidney Transplantation.Kidney international reports · 2024Article
- Anti-HLA Class II Antibodies Are the Most Resistant to Desensitization in Crossmatch-positive Living-donor Kidney Transplantations: A Patient Series.Transplantation direct · 2024Article
- Current and emerging tools for simultaneous assessment of infection and rejection risk in transplantation.Frontiers in immunology · 2024Review
- Characteristics of Early Antibody Mediated Rejection in Antibody Incompatible Living Donor Kidney Transplantation.Transplant international : official journal of the European Society for Organ Transplantation · 2024Article
- Pre-transplant crossmatch-negative donor-specific anti-HLA antibody predicts acute antibody-mediated rejection but not long-term outcomes in kidney transplantation: an analysis of the Korean Organ Transplantation Registry.Frontiers in immunology · 2024Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundMore than 40% of patients awaiting a kidney transplant in the UK are sensitised with human leucocyte antigen (HLA) antibodies. Median time to transplantation for such patients is double that of unsensitised patients at about 74 months. Removing antibody to perform an HLA-incompatible (HLAi) living donor transplantation is perceived to be high risk, although patient survival data are limited. We compared survival of patients opting for an HLAi kidney transplant with that of similarly sensitised patients awaiting a compatible organ.
methodsFrom the UK adult kidney transplant waiting list, we selected crossmatch positive living donor HLAi kidney transplant recipients who received their transplant between Jan 1, 2007, and Dec 31, 2013, and were followed up to Dec 31, 2014 (end of study). These patients were matched in a 1:4 ratio with similarly sensitised patients cases listed for a deceased-donor transplant during that period. Data were censored both at the time of transplantation (listed only), and at the end of the study period (listed or transplant). We used Kaplan-Meier curves to compare patient survival between HLAi and the matched cohort.
findingsOf 25 518 patient listings, 213 (1%) underwent HLAi transplantation during the study period. 852 matched controls were identified, of whom 41% (95% CI 32-50) remained without a transplant at 58 months after matching. We noted no difference in survival between patients who were in the HLAi group compared with the listed only group (log rank p=0·446), or listed or transplant group (log rank p=0·984).
interpretationSurvival of sensitised patients undergoing HLAi in the UK is comparable with those on dialysis awaiting a compatible organ, many of whom are unlikely to be have a transplant. Choosing a direct HLAi transplant has no detrimental effect on survival, but offers no survival benefit, by contrast with similar patients studied in a North American multicentre cohort.
fundingUK National Health Service Blood & Transplant and Guy's & St Thomas' National Institute for Health Research Biomedical Research Centre.
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