Twelve Years' Experience with National Sharing of HLA-Matched Cadaveric Kidneys for Transplantation

Through an agreement among U.S. transplantation centers, the United Network for Organ Sharing (UNOS) established a program in 1987 to ship kidneys anywhere in the United States to a recipient who had the same HLA-A, B, and DR antigens as the donor. By September 1999, 7614 HLA-matched kidney transplantations had been performed. Despite concern about the cost effectiveness and value of this program, the results of the first 1386 HLA-matched transplantations were very promising. 1 Since that time, there have been substantial improvements in immunosuppression protocols, the criteria for the acceptance of organs have been broadened to include older donors, 2 and . . .