Increased Access to Transplantation for Blood Group B Cadaveric Waiting List Candidates by Using A 2 Kidneys: Time for a New National System?

Since blood group B end‐stage renal disease (ESRD) patients have less access to donor kidneys and a higher minority composition than any other blood group, the United Network for Organ Sharing (UNOS) approved a voluntary national kidney allocation variance to allow organ procurement organizations (OPOs) to preferentially allocate A 2 and A 2 B kidneys to B candidates. The Midwest Transplant Network OPO has preferentially allocated and transplanted kidneys from blood group A 2 and A 2 B donors to our blood group B waiting list candidates for more than 7 years to increase access to kidneys for the B candidates on our OPO‐wide waiting list. Between 1994 and 2000, a total of 121 blood group B ESRD patients from our OPO‐wide cadaveric kidney waiting list were transplanted. Thirty‐four per cent (41/121) of those B candidates received either an A 2 or an A 2 B kidney. One‐ and 5‐year graft survival rates for the group of B recipients of A 2 or A 2 B kidneys were 91 and 85% (died with functioning graft [DWFG] censored), respectively, which were not significantly different from those of 91 and 80% for the 80 B recipients of B or O kidneys (Wilcoxon = 0.48; log‐rank = 0.55). These data support the national trial for additional OPOs to voluntarily allocate A 2 and A 2 B kidneys preferentially to B waiting list candidates, thus increasing access of blood group B patients to renal transplantation.