Access to the kidney donor pool for racial minority population is maximized by a variance of the UNOS point system--a regional experience. Regional Organ Bank of Illinois.
1. A local variance of the UNOS point system that awards no points to lesser HLA matches and gives slightly more weight to PRA and waiting time was evaluated by examining waiting times to transplant for 1,342 transplant candidates listed during a 3-year period (1989 through 1991). 2. Patients experienced long waiting times attributed to a large waiting list and donor shortage, but the differences in median waiting time between Blacks (22 months) and non-Blacks (17 months) was smaller than what has been reported for patients nationwide. 3. The longer waiting times for Blacks and fewer Blacks being transplanted correlated with a greater proportion of Blacks, especially females, being sensitized (current PRA > 10%) and largely accounted for the larger median waiting time difference for Blacks versus non-Blacks. 4. Transplants which occurred within the first 6 months after the patients were listed had a higher percentage of well-matched (1 B,DR or fewer mismatches) recipients, both among Blacks and non-Blacks, the shortening of the waiting time being due to points received for good matches. The higher percentage of non-Black donors allowed for fewer well-matched kidneys to be distributed to Blacks and therefore a lower percentage of Blacks were transplanted within the first 6 months (10% vs 15%). 5. Recipients of less well-matched kidneys from non-Black donors were Blacks and non-Blacks in nearly the same proportion as they are represented on the waiting list. This equal distribution was attributed to the elimination of points for lesser matches in our allocation scheme.(ABSTRACT TRUNCATED AT 250 WORDS)
Lazda
V A
VA
Loyola University, Maywood.
D000293:Adolescent; D044383:Black People; D005260:Female; D006297:Health Services Accessibility; D006648:Histocompatibility; D006801:Humans; D007087:Illinois; D016030:Kidney Transplantation; D008297:Male; D008913:Minority Groups; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods*; D014850:Waiting Lists; D044465:White People; D001741:Black or African American