The impact of the identification and inclusion of acceptable HLA-mismatches on the transplant potential of highly-sensitised renal transplant candidates.

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In Australia, allocation of donor kidneys are currently weighted largely on the degree of donor-recipient HLA compatibility. However, not all HLA mismatches leads to negative outcomes. Acceptable HLA-mismatches are antigen mismatches that can be considered compatible at a structural and functional level and have been applied to circumvent the problem of difficulty finding suitable donors for highly-sensitised transplant candidates. We apply this concept to the Australian kidney transplant population.