title: The new kidney allocation system does not equally advantage all very high cPRA candidates - A single center analysis.
abstract: The new UNOS kidney allocation system awards very high points to candidates with cPRA 99% and 100%, and allows for national sharing for cPRA 100% candidates. We sought to determine the effect of this new kidney allocation system on candidates who are very highly sensitized (90-98% cPRA) but not eligible for very high points or national sharing by examining offers to these candidates for 5months pre-implementation and two consecutive 5month periods post-implementation and comparing them to cPRA⩾99% candidates. We found that the cPRA⩾99% candidates received significantly more offers and transplants after implementation, while offers and transplants to the 90-98% candidates decreased. A slight adjustment to the allocation system may be needed to provide more equitable distribution of kidneys to all high cPRA candidates.
authors: Transplantation Immunology Laboratory, Department of Surgery, Albany Medical College, 47 New Scotland Avenue, Albany, NY 12208, USA. Electronic address: hahna@mail.amc.edu.
authors: Amy B
authors: AB
authors: Hahn
authors: Transplantation Immunology Laboratory, Department of Surgery, Albany Medical College, 47 New Scotland Avenue, Albany, NY 12208, USA.
authors: Maryanne
authors: M
authors: Mackey
authors: Transplantation Immunology Laboratory, Department of Surgery, Albany Medical College, 47 New Scotland Avenue, Albany, NY 12208, USA.
authors: Don
authors: D
authors: Constantino
authors: Department of Surgery, Albany Medical Center, 50 New Scotland Avenue, Albany, NY 12208, USA.
authors: Ashar
authors: A
authors: Ata
authors: Renal and Pancreas Transplant Program, Department of Surgery, Albany Medical Center, 43 New Scotland Avenue, Albany, NY 12208, USA.
authors: Nikolaos
authors: N
authors: Chandolias
authors: Renal and Pancreas Transplant Program, Department of Surgery, Albany Medical Center, 43 New Scotland Avenue, Albany, NY 12208, USA.
authors: Reynold
authors: R
authors: Lopez-Soler
authors: Renal and Pancreas Transplant Program, Department of Surgery, Albany Medical Center, 43 New Scotland Avenue, Albany, NY 12208, USA.
authors: David J
authors: DJ
authors: Conti
mesh_terms: D033161:Government Regulation; D006680:HLA Antigens / Q000276:immunology; D006297:Health Services Accessibility; D006650:Histocompatibility Testing; D006801:Humans; D007114:Immunization; D007518:Isoantibodies / Q000378:metabolism; D016030:Kidney Transplantation; D009927:Tissue and Organ Procurement; D066027:Transplant Recipients; D016896:Treatment Outcome; D014481:United States
chemical_list: D006680:HLA Antigens; D007518:Isoantibodies
keywords: Allocation; Antibody; Kidney; Renal; Transplant