HLA Matching in Renal Transplantation, 332 The New England Journal of Medicine 752
(1995) (with Robert Gaston and Mark Deierhoi).
Return to Professor Ayres' Homepage
Return to Professor Ayres' Resume
The competing goals of justice and optimal outcome in the allocation of cadaveric
kidneys were addressed in the September 22 issue of the Journal. Takemoto and
coauthors accept the premise that current policies place black candidates for
transplantation at a disadvantage. They propose a revised HLA-based system with
broader categories of acceptable mismatches, allowing more candidates to receive
kidneys, and they estimate that such a scheme would improve graft survival for all
recipients. However, on closer examination, the proposal offers only marginal
improvement in outcomes for black transplant recipients and fails to anticipate the effect
of the proposed system on blacks' access to transplantation.
Return to top of the Page