How do you approach induction immunosuppression in patients with high PRA undergoing lung transplantation?

At my institution, if PRA >30%, we perform preoperative plasma exchange and administer preop eculizumab along with our standard preop basiliximab and methylprednisolone. If the crossmatch is positive, we subsequently perform daily plasma exchange followed by eculizumab for the next four days. Then, ...

We do not modify induction IS based on PRA. All patients get basiliximab 20 mg on Day 0 and Day 4.

We list unacceptable antigens based on the MFI values determined in our clinical immunology lab to be predictive of a positive crossmatch. This value is 4,000 and may vary from lab to lab. We perform a...