ABO blood group influences a candidate's likelihood of receiving an HLA zero antigen mismatch kidney.
National sharing of HLA zero-mismatched kidneys has improved long-term graft survival. The distribution of those HLA-matched kidneys by ABO blood group, however, has not been examined. Utilizing the UNOS/OPTN (United Network for Organ Sharing/Organ Procurement Transplantation Network) database, we analysed 112 971 kidney waiting list registrations added during 6/3/95-31/12/00, and 8162 HLA zero-mismatched (0 mm) primary kidney transplants in the USA during 1/1/88-31/3/02. We also analyzed A isoagglutinin titer histories for 87 blood group B end stage renal disease (ESRD) patients for whom at least 1 yr of testing was done. Blood group A patients received 40.1% of the HLA-0 mm kidneys while having a 26.5% representation on the national waiting list. Blood group B patients comprised 17.4% of the waiting list, but received only 10.4% of the HLA-0 mm kidneys. Most (89.6%) blood group B patients awaiting kidney transplantation have low levels of A isoagglutinins, making them eligible to receive a blood group A(2) kidney transplant. The national HLA-0 mm kidney allocation sharing system's imbalance by ABO blood group could be partially resolved in the future by allocating HLA-0 mm blood group A(2) kidneys to B patients.
Bryan
Christopher F
CF
Midwest Transplant Network, Westwood, KS, USA. cbryan@mwtn.org
Cherikh
Wida S
WS
Cheng
Yulin
Y
Aeder
Mark I
MI
Muruve
Nicolas A
NA
Nelson
Paul W
PW
Shield
Charles F
CF
Warady
Bradley A
BA
Winklhofer
Franz T
FT
D000017:ABO Blood-Group System; D000328:Adult; D000465:Algorithms; D001787:Blood Group Incompatibility / Q000453:epidemiology*; D002648:Child; D005006:Ethnicity; D006680:HLA Antigens; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation / Q000208:ethnology / Q000276:immunology* / Q000706:statistics & numerical data; D008297:Male; D018570:Risk Assessment; D009927:Tissue and Organ Procurement; D014481:United States / Q000453:epidemiology; D014850:Waiting Lists
D000017:ABO Blood-Group System; D006680:HLA Antigens