*Purpose: The OPTN implemented new policy on 10/24/19 changing how Kidney Paired Donation Pilot Program (KPDPP) priority points are awarded. The policy is intended to improve equity in access to transplant for highly sensitized candidates and pairs with difficult-to-match blood types, and to prevent the donor-candidate pool from becoming dominated by difficult-to-match pairs. The policy adopted a sliding scale for CPRA points and added points for candidate and paired donor ABO.

*Methods: OPTN data were analyzed for the characteristics of pairs who matched in KPDPP match runs in the first 4.5 months after policy revision (“post-policy”: 10/24/19-3/12/20) compared with the year prior (“pre-policy”: 10/24/18-3/12/19).

*Results: Post-policy, there were fewer matches (N=181 pre-policy vs N=141 post-policy) but a higher overall match rate (3.97% vs 4.68%) (Table). There were 8 matches for highly sensitized candidates (CPRA 98-100%) pre-policy and 6 post-policy (4.9% vs 4.7% of matches); match rates for these candidates were unchanged post-policy (0.52% vs 0.56%). The match rate increased non-significantly for candidates with CPRA 80-97% (4.05% vs 6.19%; p=0.17). Matches by candidate blood type were virtually unchanged post-policy (A: 39.6% vs 37.2%; O: 39.6% vs 40.3%; B: 19.5% vs 20.2%; AB: 1.2% vs 2.3%); match rates increased non-significantly for AB candidates post-policy (3.39% vs 18.75%, p=0.06) but were similar for other candidate blood types (A: 8.11% vs 8.11%; O: 2.08% vs 2.66%; B: 5.58% vs 5.76%). Matches for pairs with type AB and type O paired donors increased post-policy while matches for pairs with type A and type B donors decreased (AB: 1.8% vs 6.2%; O: 38.4% vs 45%; A: 40.9% vs 32.6%; B: 18.9% vs 16.3%). Match rates increased for candidates with type A, O and AB paired donors (A: 2.89% vs 3.18%; O: 6.18% vs 8.3%; AB: 1.05% vs 3.65%) and decreased for candidates with type B paired donors (3.33% vs 2.7%); no changes were statistically significant (p>0.05 for all).

*Conclusions: The KPDPP priority points revisions are intended to improve matching opportunities for highly sensitized candidates and pairs with difficult-to-match blood types, and to add liquidity to the pair pool over time by not depleting easier-to-match pairs. Although initial results are not statistically significant, a net positive impact may be observable with more time; this will be further assessed.

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