A University of Pittsburgh study contradicts the notion that the prospects for African Americans to receive better-matched kidneys can be improved by the cross-reactive antigen group (CREG) method of matching donated kidneys to patients.
The investigators found that only about 2% of African Americans but 10% of patients of other races who underwent kidney transplantation between 1991 and 1995 received perfectly matched kidneys. Led by Thomas E. Starzl, MD, PhD, the authors reported in October in Transplantation (1997;7:983-991) that the kidney allocation system used by the United Network for Organ Sharing (UNOS) inherently favors non-African Americans because too heavy an emphasis is given to donor-recipient compatibility measures through HLA matching, the results of which can be influenced by racial differences.
The researchers studied HLA and CREG matching methods in about 33,000 kidney transplants performed in the United States to determine if patient survival or graft longevity were influenced by matching. "HLA compatibility scoring arguably has had little effect on overall survival while prejudicing the transplant candidacy of African Americans and other hard-to-match populations," the authors reported. "Although CREG matching is currently being promoted…its future role can only be considered speculative."
In June, UNOS announced that it will undertake a three-year pilot study to determine if CREG matching will improve the transplant situation for African Americans. "A shortage of minority donors has made it difficult to find well-matched kidneys for minority patients in need using standard compatibility matching guidelines. The distribution of CREG antigen groups are similar among all races," UNOS said when it announced the study.
However, research findings by the university "call into question the usefulness of such a study and the amount of priority given to any kind of matching system for allocation." said a press release issued by the University of Pittsburgh. The press release, which details the research results that led to the authors’ conclusions, can be accessed at http://www.upmc.edu/News/creg.htm.
For Your Information:
The full text of the UNOS press release announcing the pilot study can be viewed at http://www.unos.org/pr_062697.htm
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