Sensitization 1986: Prevalence and Sources Across European Waiting Lists

Abstract

The crossmatch test, though imperfect, is in effect the only safeguard against hyperacute rejection of a kidney graft. When positive, the crossmatch test vetoes transplantation. This veto means that highly sensitized patients, because they react positively with more than 80% of donors, accumulate on waiting lists and are increasingly prevalent amongst renal failure patients awaiting transplantation, especially so in countries where transplantation has been longer established. Unchecked, this process could lead to dialysis places being blocked by virtually untransplantable patients. Schemes aimed at giving priority in organ allocation to highly sensitized patients have been introduced, and are reviewed in Chapter 9; these have been partially successful (see Chapter 6). This chapter takes a 1986 snapshot of sensitization. In it, European registries are compared with regard to the proportion of patients at different levels of sensitization who are awaiting kidney transplantation (PREVALENCE 1986). The associations of sensitization status with sex, graft number (first versus regraft) and blood group (0 versus non-0) are also explored (SOURCES).