In the Kidney Allocation System (KAS), adult kidney candidates who are a zero Human Leukocyte Antigen (HLA) ABDR-mismatch with a potential donor are given priority in the match run over non-zero HLA ABDR-mismatch candidates. Furthermore, KAS allows for the shunting of kidneys to zero-mismatch candidates across compatible ABO blood types, potentially disadvantaging O candidates who have longer waiting times. This study was undertaken to determine who is receiving zero HLA ABDR-mismatch kidneys, the number of donors shunted to non-identical ABO recipients, the impact on dialysis exposure before transplant, and the current patient and graft outcomes.