New Study finds Racial Inequality Prevalent for Kidney Recipients

November 12, 2012

New Study finds Racial Inequality Prevalent for Kidney Recipients

A study published in the American Journal of Kidney Diseases has identified that a significant inequality still exists in the numbers of kidney transplants available to black people. This is after a kidney allocation policy reversal allowing for more opportunities for the black patients.

The United Network for Organ Sharing (UNOS) protocol, up until 2003 gave precedence to any potential recipients whenever a genetic match with the deceased donor was seen. The measure of compatibility lay in how closely matched the HLA-B, which is an antigen which deals with the body’s likelihood of rejecting new (foreign) tissue. Because HLA-B is more similar in same race groupings it meant that black people had a smaller chance of being selected.

Before this policy reversal white patients were far more likely to receive a donor kidney because there were also a higher number of white donors. However even after the reversal researchers from Johns Hopkins School of Medicine found that before the reversal in 2003, blacks were 37% less likely to receive a donor kidney transplant yet after the reversal black patients were still 23% less likely to get a donor kidney transplant. These findings were gleaned from nearly 179,000 patients whose details are on the kidney transplant list.

The researchers acknowledge that there is still a considerable inequality and believe that the cause is due to patients and caregivers behavior and thinking. The study senior author Dr. Dorry Segev, said, “For example, a patient may be reluctant to accept certain organ offers, or there may be geographic disparities involved”.

He then goes on to explain that people’s perception of a situation may not be true when has says, “Another possibility is the conventional thinking that African Americans do better on dialysis than Caucasians. If a patient or his physician feels that he will do just fine on dialysis, he will be more reluctant to accept the up-front risk of the transplant. Studies have found that while this is true in older patients, it is actually the opposite in younger ones. Younger African Americans do far worse on dialysis than their Caucasian counterparts”.

The National Kidney Foundation says that presently almost 90,000 Americans are on the list for a kidney transplant. It also points out that kidney failure is almost three times as common in black people compared to whites. The figures are 783 per million for blacks and 295 per million for whites.


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