As long as the demand for transplantable organs exceeds the supply, fair and equitable organ allocation policies will be of utmost importance. However, these policies are often contentious and must balance a variety of disparate interests. Current kidney allocation policies in the United States have resulted in profound variations in waiting times for patients on the cadaveric renal transplant waiting list. For example, tenfold differences in average waiting times exist for patients of the O blood group based on their geographic location. The policy of national sharing of 0 HLA mismatched kidneys may contribute to some degree of equity in kidney allocation by evening the playing field for patients in all geographic locations. However, this policy is not universally embraced. Thus, Lee and colleagues should be congratulated for their critical analysis of this policy in their article.1
Ratner LE. Prolonged Preservation Time Obviates the Benefits of 0 HLA Mismatches in Renal Transplantation. Arch Surg. 2001;136(4):474. doi:
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