文摘
The new UNOS kidney allocation system awards very high points to candidates with cPRA 99% and 100%, and allows for national sharing for cPRA 100% candidates. We sought to determine the effect of this new kidney allocation system on candidates who are very highly sensitized (90–98% cPRA) but not eligible for very high points or national sharing by examining offers to these candidates for 5 months pre-implementation and two consecutive 5 month periods post-implementation and comparing them to cPRA ⩾ 99% candidates. We found that the cPRA ⩾ 99% candidates received significantly more offers and transplants after implementation, while offers and transplants to the 90–98% candidates decreased. A slight adjustment to the allocation system may be needed to provide more equitable distribution of kidneys to all high cPRA candidates.