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UK Highly Sensitised Allocation Scheme — ESENeph MCQ

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ModerateTransplantationUK Highly Sensitised Allocation SchemeESENeph

A kidney transplant candidate has panel reactive antibodies (cRF) of 100%. She has had three previous transplants, multiple blood transfusions, and two pregnancies. What special allocation scheme exists in the UK to help highly sensitised patients access transplantation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — The National Kidney Sharing Scheme and the Highly Sensitised Patient scheme within NHSBT prioritise allocation of well-matched kidneys to highly sensitised patients

NHSBT operates specific allocation schemes for highly sensitised patients. The Highly Sensitised Patient scheme identifies acceptable HLA mismatches that the patient does NOT have antibodies against (permissible mismatches) and prioritises nationally allocated kidneys matching these permissible antigens. The National Living Kidney Sharing Scheme includes paired exchange and altruistic donor chains, which can help sensitised patients find compatible donors. These schemes have dramatically improved transplant access for highly sensitised patients in the UK.

Reference: NHSBT 2023 – Kidney Allocation Policy; BTS – Sensitisation Guidelines