New Policy Improves Kidney Transplant Rates for Minorities

Elimination of priority for HLA-B matching improves rates with no adverse effect on graft survival

FRIDAY, July 29 (HealthDay News) -- Changes to the U.S. kidney allocation system in 2003, which eliminated priority for human leukocyte antigen-B (HLA-B) similarity improved deceased-donor kidney transplantation among minorities without affecting the two-year graft survival during the first six years following the policy change, according to a study published online June 14 in the American Journal of Transplantation.

Valarie B. Ashby, from the University of Michigan in Ann Arbor, and colleagues analyzed the deceased-donor kidney transplant outcomes during the six years before and after the U.S. kidney allocation system was changed in 2003. Data from 108,701 solitary deceased-donor kidney recipients from the scientific registry of transplant recipients (SRTR) were analyzed. Chi-square and Cox models were used to analyze the racial/ethnic distribution of recipients and graft failures, respectively.

The investigators found that there was a 23 percent increase in the overall number of deceased donor transplants in the six years following the policy change compared to the six years before the policy change. A significantly larger increase was observed in the proportion of transplants among non-whites compared to whites (40 percent among minorities versus 8 percent among non-Hispanic whites). All racial/ethnic groups showed an improvement in the two-year graft survival after implementation of this new policy. The SRTR predictions were confirmed by the findings.

"This new policy improved equity in access to deceased donor transplantation among wait-listed candidates without impairing posttransplant outcomes," the authors write.

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