*PURPOSE: Review outcomes of deceased donor kidney transplants (KTXs) from non-A1/non-A1B donors to blood group (BG) B recipients. *METHODS: Single center review of deceased donor kidney alone transplants since the implementation of the kidney allocation system (KAS) in December 2014 to 4/30/2022 with follow-up through 9/1/2022. All BG B candidates underwent anti-A titer checks by the tube method at evaluation to establish candidacy for non-A1 listing. Acceptable anti-A titers were < 1:8 and subsequently increased to ≤1:64. Titers were checked every 3 months while on the waitlist, the day of KTX and 2 days after. We compared outcomes between recipients of BG B/O to B and A2/A2B to B. *RESULTS: 305 BG B recipients received KTXs; of those, 76 (25%) received non-A1/non-A1B KTXs. The non-A1/non-A1B group was more likely to be transplanted faster, avoid dialysis and receive an organ from outside of the local OPO (Table). Cold ischemia time and delayed graft function rates were similar. GFR was slightly lower at 4 months and 1 year but 1 year and 5-year graft survival rates were similar (Table, Fig1). There was 1 AMR event in the non-A1/non-A1B group that was related to HLA antibodies. In most cases (79%), the titers were reduced or unchanged posttransplant (Fig2). [

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] *CONCLUSIONS: In select BG B candidates, KTX from a non-A1/non-A1B deceased donors offer an opportunity for shorter wait times while maintaining excellent outcomes. This option continues to be underutilized despite safety, efficacy and potential benefits for the disadvantaged minority groups.CITATION INFORMATION: Khamash H., Jadlowiec C., Budhiraja P., Mathur A., Abu Jawdeh B., Reddy K., Adamski J., Kinard T., Katariya N., Chakkera H., Me H., Heilman R. Improving Access to Transplant: Non-A1/Non-A1B to Blood Group B Deceased Donor Kidney Transplants AJT, Volume 23, Issue 6, Supplement 1.

Hasan Khamash M.D.

Mayo Clinic Arizona

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