UNOS Revises Kidney Allocation Policy To Aid African Americans

The United Network for Organ Sharing (UNOS) Board of Directors has voted to revise its kidney allocation priority for tissue matching in a way that is expected to increase the number of donor kidneys available for transplant to African Americans.

A UNOS spokesperson said computer modeling indicated the policy change would allow more than 200 additional kidney transplants annually for African Americans.

The change addresses human leukocyte antigen (HLA) matching, which measures immune system compatibility between an organ donor and patient. Three pairs of HLA antigens are compared between donor and patient.

Since HLA matching has long been linked to better survival of the transplanted kidney, patients on the waiting list who have a higher level of HLA match with a potential donor have received higher priority for available kidneys.

Top national priority has always been given -- and will continue to be given -- to patients who have a "perfect" HLA mismatch with a specific donor.

But recent scientific analysis has indicated that HLA matching priority could be reduced somewhat, and under the revised policy, allocation priority will only be given for patients whose antigens match one or both donor antigens at one specific pair, known as the "DR locus."

"We feel that issues of justice, fairness and equity are clearly addressed by this proposal," said Dr. Winfred Williams, chairman of the Minority Affairs Committee. "We hope that our emphasis on ensuring equity will boost the public's confidence in the transplant system."

UNOS said the change will be implemented as soon as it can be programmed into the nationwide computerized system that matches donors and recipients. The Board also resolved to further study the impact of the revised priority and may consider later modification.

Other sources: UNOS