1.1
#16
TWO-YEAR ANALYSIS OF THE OPTN/UNOS CREG ALLOCATION VARIANCE.
Steven K. Takemoto, PhD , Alan Leichtman MD , Christine Tolleris MPA and Alan Ting PhD . Los Angeles CA, Immunogenetics Center, UCLA, 90095, Pathology and Surgery ; Ann Arbor MI, University of Michigan and Richmond VA, UNOS .

---

A prospective study conducted by the United Network for Organ Sharing (UNOS), in its capacity as the OPTN contractor, compared two cadaveric-donor kidney allocation algorithms and their impact on the percentage of racial minority recipients and graft outcome.
Between January 1999 and November 2002, 3116 donors were prospectively randomized to allocation algorithms giving priority either to recipients with 0-CREG, and 0-HLA-DR mismatches (CREG), or to those with the fewest HLA-B, and -DR mismatches (BDR).
The CREG-based algorithm promoted allocation of kidneys to non-White recipients. Overall, the percentage of kidneys to non-white recipients was 35, 42 and 51% for 0-1 BDR, 2 BDR and >2 BDR mismatched transplants (P<0.001) compared to 42 vs. 46% for 0-CREG mismatched vs. >0 mismatched transplants (P=0.208). Two-year graft survival was 86% for 0-1 B-DR and 0 CREG mismatched transplants compared to 81% for transplants with >1BDR or CREG mismatches.
This prospective randomized study suggests that CREG matching reduces inequities in cadaveric renal transplant allocation arising from inequality between those HLA antigens common in the predominantly White donor population and those in the more racially diverse pool of wait listed. Overall outcome was similar in the two study arms, but within the CREG arm, 0 CREG, 0 DR mismatched recipients had fewer rejections and higher graft survival than those with CREG and/or DR mismatches.