Effect of class I HLA matching on graft survival in sensitized patients

First, the proportion of highly sensitized transplant candidates grows in the absence of organ sharing. The unsensitized patient is transplanted readily; the sensitized patient has restricted access because of the need for a well-matched kidney to permit a negative cross-match. Second, well-matched grafts are equally successful in sensitized and unsensitized recipients. Finally, emphasis on organ sharing would reverse the trend of accumulation of sensitized candidates without decreasing graft survival.