What Does It Mean to be Sensitized in Kidney Transplants (and Why It Matters for Finding the Right Living Donor)
If you need a kidney transplant and have been told that you are “sensitized,” you might be wondering what that really means—and what you can do about it.
What is Sensitization?
Being sensitized means your immune system has developed antibodies that make it harder to find a compatible organ for transplant. These antibodies may come from a past transplant, blood transfusions, or even pregnancy. They cause your immune system to react more strongly to certain donor kidneys, which can increase your risk of rejection.
To assess how sensitized a person is to potential organ donors, doctors use a measurement called cPRA (calculated Panel Reactive Antibody). If your cPRA is over 80%, you are considered “highly sensitized,” meaning your body would likely reject about 80% of donor kidneys.
Why Does Sensitization Matter?
The more sensitized you are, the harder it becomes to find a compatible kidney. But there’s good news: sensitized patients can still achieve successful transplants through living donor kidney swaps. And today, the outcomes are better than ever.
According to the National Kidney Registry’s (NKR) 2025 Outcomes Report, highly sensitized patients who received a kidney through an NKR swap had a 38% lower graft failure rate at three years compared to similar patients who did not participate in an NKR exchange. At five years, that number remained significantly lower at 28%.
In fact, in 2024, the NKR facilitated 49% of all living donor transplants in the U.S. for highly sensitized patients.
How Does the NKR Help?
The NKR uses advanced matching technology to connect patients and donors across the country. Even if your donor isn’t a perfect match, you can still enter a paired exchange (a “swap”), where your donor donates a kidney to someone else and you receive a kidney from a better-matched donor in return.
When considering donor-recipient compatibility, the NKR also considers eplet matching, which goes beyond blood type and basic compatibility. Data shows that kidney transplants with fewer eplet mismatches lead to much better outcomes.
Even if your donor is technically a match, going through the NKR could help you find an even better match—one that may lead to a longer-lasting transplant and better overall outcomes.
What Should You Do Next?
Ask your transplant center about your cPRA to find out if you’re sensitized.
If you have a living donor, talk to your coordinator about joining the NKR to access a better match and potentially better outcomes.
If you don’t have a donor yet, the NKR can help connect you through their national network and provide you with tools to support your donor search.
Being sensitized doesn’t mean you’re out of options. With the right tools and support, you can find a living donor and have a successful transplant.