*Purpose: A significant limiting factor to transplantation resides on waiting time based on blood type. Historically candidates in blood groups B and O experience higher waiting times for kidney transplantation. Our center has worked to increase the rate of acceptance in kidneys that would have previously been discarded to try and maximize the donor pool for these blood groups.

*Methods: We retrospectively analyzed 1287 consecutive deceased donor kidney transplants from 2015 to 2019. This cohort was chosen based on initiation of changes to the allocation system in 12/2014, favoring these disadvantaged groups. Average waiting time to transplantation and renal transplantation rates were analyzed based on ABO stratification as well as ethnicity to compare longitudinal disparities.

*Results: We observed a decrease in waiting time across all blood types (Table 1) over the 5 year period of this study. There was a substantial benefit in blood type B recipients with a 6.4 year decrease in average waiting time from 2015 to 2019. Waiting time in blood type O recipients decreased by 3.4 years from 2015-2019 (Table 1). We observed a decrease in disparity between African Americans and Hispanics versus Caucasians, with average waiting times decreasing from 2.5 years to 1.2 years and 1.6 years to 0.5 years, respectively. There were no type B recipients who received A2 donors in this cohort.

*Conclusions: Waiting time at our center decreased significantly across all blood types with a disproportional benefit in blood group B recipients despite not utilizing the benefit of A2 donors transplanted into B. Thus, this reflects our increase in volumes by utilizing extended criteria donors such as acute kidney injury and high kidney profile index donors (KDPI). These efforts have reduced the disparities in waiting time particularly in minorities, African American descendants and Hispanic populations.

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