Association between Allosensitization and Waiting List Outcomes among Adult Lung Transplant Candidates in the United States

Rationale: Allosensitization may be a barrier to lung transplantation. Currently, consideration is not given to allosensitization when assigning priority on the lung transplant waiting list. Objective: We aimed to examine the association between allosensitization and waitlist outcomes. Methods: We conducted a retrospective single-center cohort study of adults listed for lung transplantation at our center between 1/1/06 and 12/31/16. We screened candidates for human leukocyte antigen (HLA) antibodies prior to listing and examined the association between allosensitization and waitlist outcomes, including likelihood of transplantation and death on the waiting list, using a competing risk model. Calculated panel reactive antibody (CPRA) was utilized as a continuous measure of allosensitization. Results: Among 746 candidates who were listed for lung transplantation during the study period, 263 (35%) were allosensitized and 483 (65%) were not. In unadjusted analysis, allosensitized candidates had a decreased li...