UNOS: 1989

This paper provides the current data which has been accrued by the UNOS National Scientific Registry as a result of the mandatory sharing of 6-antigen matched kidneys. The 6-month graft survival does not show, as yet, any benefit for first grafts (N = 72), but does show substantial benefit for repeat grafts (N = 25). No penalty from sharing could be demonstrated since graft survival for local and shared organs was the same. The rationale for two new UNOS policies are discussed: (1) mandatory sharing of phenotypically identical kidneys, (2) the "payback system" for shared kidneys. Finally, some personal comments of the author regarding the importance of the National Organ Procurement and Transplant Network are recorded.