Sensitization is a small gate for lungs — but a heavy one at the top.
Most lung candidates carry no anti-HLA antibody, so sensitization constrains far fewer than in kidney. But the highly sensitized tail pays a real price in waiting time — the population where epitope-level matching would help most.
Source: OPTN/UNOS STAR file, Dec 2025 release · lung/heart-lung transplants; cPRA proxied by peak class I/II PRA (recorded for ~27% of transplants).
72 → 127 d
Median wait to transplant rises from 72 days for unsensitized candidates to 127 days at cPRA 80–100% — a 1.8× longer wait for the most sensitized 1% of recipients.
01 · Distribution
Most lung recipients are unsensitized
Share of lung transplants by peak-PRA band. Unlike kidney, the highly sensitized are a small minority.
Sensitization band (% of transplants)
02 · Access cost
The sensitized tail waits longer
Median days from listing to transplant by sensitization band, among transplants with recorded PRA.
Median wait to transplant (days)
This is where PIRCHE-style epitope matching earns its keep. For the highly sensitized minority, antigen-level matching leaves few compatible donors; predicting indirectly-recognizable epitope load could widen the acceptable-donor set and shorten the tail — see VitalMatch's HLA feasibility work.