Effect of HLA matching on organ distribution among whites and African-Americans

A total of 159 patients received renal cadaveric grafts under 2 different allocation systems. System 1, a local variance (i.e., a point system different from that of United Network for Organ Sharing [UNOS]), and system 2, the current UNOS point system, differed in the relative emphasis on waiting time and HLA match. The racial composition of the donor pools and recipient waiting lists was the same for both periods examined. The percentage of African-Americans transplanted did not differ significantly under the 2 allocation systems and, in fact, increased slightly, from 29.4% to 33.8%, under system 2, which attributed more weight to HLA match. A difference in the allocation of kidneys from African-American donors was seen. Under system 1, only 2 of 8 kidneys from African-American donors went to African-American recipients, while under system 2, 6 of 8 kidneys from African-American donors went to African-American recipients. These data suggest that the current UNOS point system does not provide any added disadvantage to non-whites and may, in fact, provide an incentive for minority groups to donate organs, in that HLA matching appears to promote intraracial transplantation.