EMBARGOED FOR PUBLIC RELEASE: February 5, 2004

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CHANGING PRIORITY FOR HLA MATCHING COULD REDUCE RACIAL INEQUITIES IN ORGAN ALLOCATION

Removing HLA-B matching as a priority for kidney transplant waiting lists shown to reduce racial imbalance in organ allocation

Ann Arbor, MI -- Research published today in the New England Journal of Medicine shows that removal of Human Leukocyte Antigen-B (HLA-B) matching as a priority for allocation of cadaveric kidneys could increase the number of kidney transplants among non-whites in the U.S. by as much as 6.3%. This change could produce a 4.0% decrease in kidney transplants for whites.

"This research illustrates the relationship between the utility of HLA matching and the racial inequities that develop from it. Changing the allocation policy based on the findings here is expected to reduce that inequity with little adverse effect on post-transplant outcomes," says Dr. John P. Roberts, a transplant surgeon at the University of California at San Francisco and lead author of the article, "The Effect of Changing the Priority for HLA Matching on the Rates and Outcomes of Kidney Transplantation in Minority Groups."

HLA typing and the time a patient spends on the waiting list are used to determine kidney allocation in the U.S. Patients with no HLA mismatches are given top priority, followed by those with the fewest mismatches at the HLA-B and HLA-DR loci, since better HLA matching improves transplantation outcomes. Because of differences in common HLA profiles, white patients tend to have fewer mismatches at HLA-B loci than non-white patients and receive more transplants under the current kidney allocation system.

Since this research demonstrated very little benefit with better HLA-B matching, the national rules for kidney transplantation were changed in May 2003 to no longer give priority points for fewer HLA-B mismatches. "Our research supports the premise that this new national rule offers a fairer chance for a kidney transplant to patients of all race groups," says Dr. Friedrich K. Port, President of the University Renal Research and Education Association and a co-author of the article.

Dr. Roberts' findings are based on data and analyses from the Scientific Registry of Transplant Recipients (www.ustransplant.org).

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The University Renal Research and Education Association (URREA) is a not-for-profit organization with a unique combination of expertise in the design and execution of research studies including primary data collection and the development of large clinical databases and state-of-the-art statistical analyses. URREA, in collaboration with the University of Michigan, is the contractor for The Scientific Registry of Transplant Recipients (SRTR), supporting the ongoing evaluation of the scientific and clinical status of all solid organ transplantation under contract with the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA).

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