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In contrast, the percentage of two HLA-DR mismatches increased in those same intervals from 26% to 40%. Overall, the adjusted relative graft survival percentages in the cohorts assessed 2 years after transplantation were higher after the policy change than before it (p http://www.selleck.cn/products/pd-1-pd-l1-inhibitor-2.html Hispanic/Latinos, Asians and Native Americans was not statistically different among the four cohorts (May 1997 to May 2000, May 2000 to May 2003, May 2003 to May 2006 and May 2006 to May 2009), although it was higher among postpolicy transplant recipients than prepolicy recipients. Two-year graft survival increased, from 87.6% to 90.2% for zero mismatch recipients and from 83.0% to 86.7% for nonzero mismatch recipients from the 1997�C2000 cohort to the 2006�C2009 cohort. Substantial improvements were observed in the outcomes of both HLA-B mismatched and HLA-B nonmismatched transplants. A subgroup analysis done separately for standard criteria donor (SCD) and ECD transplants showed that the trends in the percentage distribution by race/ethnicity displayed in Figure 1 were very similar for SCD kidney transplants; however, for ECD http://www.selleckchem.com/products/gsk1120212-jtp-74057.html transplants, the percentage of organs received by nonwhites changed little during the last three time periods. For illustration purposes, Figure 3 presents the active waiting list (N = 54 265) on the day before the policy change (May 6, 2003), by time since wait-listing. The consequences of reducing allocation points for HLA similarity from two, five and seven to only one and two can be predicted from an understanding of the point-prevalent snapshot of time on the waiting list by years. Figure 3 illustrates that receiving seven or five points for zero or for one combined HLA-B and DR mismatch would allow candidates to jump ahead of almost the entire national waiting list. With similar waiting times, candidates given five and seven points would receive organs before high-PRA candidates (who received http://www.selleckchem.com/products/MDV3100.html a four-point advantage) (11). Therefore, reducing the allocation priority for HLA-DR similarity to a maximum of two points resulted in greater access to transplantation for children and high-PRA candidates. The smaller percentage of zero HLA-DR mismatches is likely a reflection of the decrease in the number of points potentially provided for HLA-DR similarity. This resulted in a relative shift in overall allocation priority away from HLA-DR matching and toward waiting time. The observed shift in organs from the white candidate pool to the minority pool persists even after the first 2 years of the new policy; it is consistent with and validates the results of the preimplementation SRTR statistical models (14).