First Report on the OPTN National Variance: Allocation of A2 /A2 B Deceased Donor Kidneys to Blood Group B Increases Minority Transplantation.

Academic Article

Abstract

  • In 2002, the Organ Procurement and Transplantation Network (OPTN) Minority Affairs Committee (MAC) implemented a national, prospective, "variance of practice" to allow deceased donor, ABO blood group incompatible, A2 antigen, kidney transplantation into blood group B recipients; outcomes of this cohort were compared to ABO compatible recipients. The goal of the variance was to increase the number of transplants to B candidates without negatively impacting survival or compromising system equity. Only B recipients with low anti-A IgG titers (<1:8) were eligible to receive these kidneys. Across eight participating Donation Service Areas (DSA), there were 101 A2 /A2 B to B transplants through 12/31/11, of which the majority of the recipients (61%) were ethnic minorities. At 12, 24, and 36 months, Kaplan-Meier graft survival rates for the B recipients of A2 /A2 B kidneys were 95.0%, 90.6%, and 85.4%, respectively, comparable to outcomes for B recipients of B kidneys, 92.6%, 87.9%, and 82.5%, respectively (p-value = 0.48). Five DSAs increased the proportion of B transplants during 41 months postvariance, with a lesser proportional decrease in blood group A transplants. The data support the proposition that this allocation algorithm may provide a robust mechanism to increase access of blood group B minority candidates to kidney transplantation.
  • Authors

    Published In

    Keywords

  • Organ Procurement and Transplantation Network (OPTN), United Network for Organ Sharing (UNOS), health services and outcomes research, kidney transplantation/nephrology, organ procurement and allocation, recipient selection, waitlist management, ABO Blood-Group System, Adolescent, Adult, Aged, Blood Group Incompatibility, Cadaver, Child, Child, Preschool, Ethnic Groups, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Isoantibodies, Kidney Transplantation, Male, Middle Aged, Minority Groups, Prognosis, Resource Allocation, Survival Rate, Tissue Donors, Tissue and Organ Procurement, Young Adult
  • Digital Object Identifier (doi)

    Pubmed Id

  • 23916363
  • Author List

  • Williams WW; Cherikh WS; Young CJ; Fan PY; Cheng Y; Distant DA; Bryan CF
  • Start Page

  • 3134
  • End Page

  • 3142
  • Volume

  • 15
  • Issue

  • 12