Wcn26-542 Organ Allocation and Transplant Equity in Brazil: The Hidden Burden of Hla Homozygosity and Hypersensitization

Kidney transplantation remains the most cost-effective treatment for end-stage renal disease (ESRD), yet the global scarcity of donor organs leads to prolonged waiting times and disparities in access. In Brazil, despite a well-established public transplant program, immunological barriers such as HLA sensitization and homozygosity continue to limit transplant opportunities. The current allocation system prioritizes candidates based on ABO compatibility and mismatches at the HLA-A, -B, and -DR loci, but lacks specific policies for highly sensitized or homozygous patients.