Table 1.

Summary of major changes to kidney allocation policy

Date	Policy Change
February 28, 1989	Four points for candidates with PRA = 80%.
August 1, 1995	Point system modified to assign 1 point for longest waiting time with fractions for shorter times, plus 1 point for each year of waiting beyond the first year.
September 2, 1996	Extra points assigned for living organ donors who subsequently develop end-stage renal disease.
January 19, 1998	Established defined medical criteria for initiating waiting time for adult kidney and kidney/pancreas candidates.
November 23, 1998	Extra points for pediatric candidates modified to assign additional priority for children who did not undergo transplant within time goals.
October 30, 2002	Defined expanded criteria donors.
May 7, 2003	Revised 0MM from blood type O donors to give priority first to blood type O candidates, then to B candidates, then to A or AB candidates.
May 7, 2003	Eliminated priority for HLA-B matching points.
May 7, 2003	Additional priority assigned at the local level of distribution for prior living organ donors who subsequently develop end-stage renal disease.
November 5, 2003	Candidates accrue waiting time even in inactive status from this point forward.
November 18–19, 2004	Time goals eliminated for pediatric candidates, new policy prioritized donors aged < 35 years to pediatric candidates after 0MM, highest scoring high CPRA, and prior living organ donors but before paybacks.
January 21, 2009	Elimination of 0MM sharing for nonsensitized adult candidates.
October 1, 2009	Change from PRA to CPRA.

0MM = zero antigen mismatch; CPRA = calculated panel-reactive antibody; PRA = panel-reactive antibody.