Abstract
P2 Aims: Since Sept. 20, 1999 our organ procurement organization (OPO) that serves an ethnically diverse local distribution area has allocated kidneys from deceased donors using a UNOS approved kidney allocation variance that awards 7 points for a 0-CREG,0-DR mismatch (MM) and 6 points for a 0-A,B MM. Points were also given for waiting time (3) and panel-reactive antibodies (PRA) >80% (3). Previously we showed that awarding points for 0-CREG,0-DR MM in kidney allocation improves the access to HLA matched transplants for all racial groups, especially the black race. In this study we evaluated if there are graft outcome benefits as well. Methods: One and 3 year uncensored graft survival (GS) data were provided by Scientific Registry of Transplant Recipients (SRTR) and analysed for the influence of HLA mismatching on graft outcome in black and non-black recipients. Results: Overall, 1 year GS was 87.4% (N=1,197) and not significantly different for blacks (86.1%, N=467) and non-blacks (88.2%, N=730); 3 year GS was 74.6% (N=1,245) and significantly lower for blacks (68.5%, N=480) vs. non-blacks (78.4%, N=765), p=0.0001.Figure* = less than 30 cases No significant improvement in GS (p=NS) was seen with HLA matching, including 0-CREG, 0-DR MM, for either the black or non-black recipients (Table) and also not seen when data was stratified for patients non-sensitized (PRA≤10%) and sensitised (PRA >10%) at the time of transplant. Of those relisted after a failed graft, the 0-A,B,DR MM group was the least sensitized (6%, N=16) as expected, and there was a trend for less sensitization in the 0-CREG,0-DR MM group (33%, N=9), compared to those with other HLA mismatches (67%, N=126). Conclusions: In conclusion, based on 1-year and 3-year follow-up data, there are no apparent graft oucome benefits for either CREG matching or conventional HLA matching in our service area. Such benefits may become apparent with longer follow-up.
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