ArticleCommunications medicine2025
Soft kidney allocation improves HLA matching and maintains allocation order.
Article in Communications medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
backgroundKidney allocation scores aim to balance transplant efficacy and equity but often deprioritize Human Leukocyte Antigen (HLA) matching, leading to reduced graft lifespan and a higher risk of donor-specific antibodies (DSA). This study introduces a "soft allocation" strategy to improve HLA match rates while minimally disrupting the allocation queue or equity.
methodsDonors include directed-living (D-LD), non-directed-living (ND-LD), and deceased (DD) types. In the "soft allocation" system, instead of automatically assigning the kidney to the first person in line, the kidney is offered to the best HLA match among the top patients on the waiting list. The predefined size of the top patient group (typically 5-20 patients) is referred to as K. This approach preserves blood type and age compatibility while protecting patients with rare HLA types.
resultsAnalysis of 95,250 US DD transplants shows an increase in HLA-A&B&DR match scores from 1.45 to 1.77. In 42 recent DD cases and 230 ND-LD transplants in Israel, match scores improved from 2.33 to 2.54 and from 1.34 to 2.03, respectively. Similar enhancements are observed in related donor-recipient pairs using crossover transplants, achieving a three-fold match improvement without worsening any recipient's match.
conclusionsFor predefined allocation rules, soft allocation enables significant HLA matching improvement with minimal impact on allocation order, benefiting both unrelated and related transplants. Future work will extend this approach to include sensitized donations.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.