Transplantation rate of the blood group B waiting list is increased by using A2 and A2B kidneys.

Background. We have increased the transplantation rate for blood group B cadaveric waiting list candidates by transplanting them with A 2 and A 2 B kidneys. Methods. Since 1991, five of the seven renal transplant programs in our organ procurement organization service area have preferentially transplanted blood group A 2 and A 2 B cadaveric kidneys to B blood group waiting list candidates with histories of low anti-A isoagglutinin titers. Results. Between 1991 and 1997, these five centers performed transplantations on 71 patients from the B cadaveric waiting list. Of those 71 patients, 29% (21 of 71) underwent transplantation with either A 2 (n=18) or A 2 B (n=3) cadaveric kidneys. In 1997 alone, 48% (11 of 23) of the B patient transplant recipients received A 2 or A 2 B kidneys. Conclusions. Transplantation of A 2 and A 2 B kidneys into B waiting list patients has successfully increased access of B patients to kidneys. Such an allocation algorithm implemented nationally may similarly increase the transplantation rate of B waiting list candidates.