SEOPF centers historically have shared kidneys at a higher rate than the rest of the United States. 2. SEOPF centers transplanted better-matched kidneys than the rest of the nation despite transplanting a significantly larger percentage of "hard-to-match" black recipients. 3. Within SEOPF centers, a shared kidney was almost twice as likely to be a good match (zero-3 HLA antigen mismatches) as was a local kidney. 4. Within SEOPF centers, well-matched kidneys (zero-3 HLA antigen mismatches) had significantly better graft survival than did poorly-matched (4-6 HLA antigen mismatches) kidneys. 5. SEOPF centers had one-, 2- and 3-year graft survival rates comparable to those of the rest of the nation. 6. SEOPF centers have proven the efficiency of ROP trays in predicting final crossmatch results for shared kidneys. 7. The SEOPF High Grade Match (HGM) algorithm has been successful in transplanting highly sensitized (current PRA > 40%) recipients. 8. The use of ROP trays in well-matched, highly sensitized recipients resulted in improved kidney availability. 9. Graft survival of HGM recipients was comparable to that of non-HGM recipients. 10. Despite longer cold ischemia times for HGM kidneys, there was no increased incidence of delayed graft function in these kidneys. 11. The HGM program accounted for 8.1% of the participating centers' activity and, thus, has not adversely impacted the majority of the centers' other patients. 12. The one- and 2-year graft survival data for HGM transplants were in accordance with the expected rates and were not statistically different from those of non-HGM transplants.
