HLA matching for improved cadaver kidney allocation

Abstract

Because long-term results of kidney transplantation are still unsatisfactory, efforts are needed to improve them, particularly through the allocation of well-matched kidneys to recipients. In the past 7 years, the United Network of Organ Sharing 6-antigen match program has established that superior results can be obtained with the national sharing of available no HLA-A, -B, or -DR antigen mismatched kidneys. In addition to strengthening this program, the 1 HLA-A, -B, or -DR antigen-permissible mismatched kidneys should also be shared nationally. Approximately half of the recipients would receive nationally matched kidneys and the remaining recipients would be allotted kidneys locally, with distribution based on fewer risk factors (eg, residues) and on waiting points. This residue matching method was shown to result in more equitable kidney distribution to minorities.