title: HLA matching and the United Network for Organ Sharing Allocation System: impact of HLA matching on African-American recipients of cadaveric kidney transplants.
abstract: BACKGROUND
  A recent proposal supports the elimination of allocation points for human leukocyte antigen (HLA) mismatches (MM) in cadaveric kidney transplantation. The intent is to increase access for some racial groups that might be disadvantaged by the representation of race-specific HLA in a largely white donor pool. We report our experience from two transplant centers that serve a large African American (AA) patient population.
  
  
  METHODS
  All cadaveric transplants into AA recipients from 1994 to 2000 (n=162) were included in a retrospective review.
  
  
  RESULTS
  Superior graft survival was observed in AA recipients of 0 MM transplants. When induction therapy was used, the graft survival at 3 years for the human leukocyte antigen (HLA)-BDR MM grades given allocation points (0,1,2 MM) was 82% versus only 49% for BDR MM grades not given points (3,4 MM: =0.0022).
  
  
  CONCLUSIONS
  Our collective experience demonstrates that AA patients having HLA-BDR MM grades given allocation points had better graft survival. Removing points for HLA from the national allocation system may result in significantly poorer outcome in AA kidney recipients.
authors.affiliation: East Carolina University Brody School of Medicine, Department of Pathology, Greenville, NC, USA.
authors.forename: Lorita M
authors.initials: LM
authors.lastname: Rebellato
authors.forename: Angelo N
authors.initials: AN
authors.lastname: Arnold
authors.forename: Karen M
authors.initials: KM
authors.lastname: Bozik
authors.forename: Carl E
authors.initials: CE
authors.lastname: Haisch
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D044383:Black People; D002102:Cadaver; D002648:Child; D005260:Female; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement