Kidney failure affects Black people four times more than it affects White people in the U.S., yet fewer Black patients receive kidney transplants across the country. A study by DaVita Clinical Research (DCR) explored where in the transplant process disparity becomes prevalent, and what should be done to improve equality. 

Where in the transplant process do racial disparities emerge?

Leveraged with data from 60,229 patients from around the country, researchers analyzed the information and excluded patients with a prior transplant or who had been evaluated for transplant prior to starting dialysis.

The researchers’ findings showed that Black patients were 22% more likely to be referred for transplant evaluation than White patients, but had an 18% lower chance of being placed on the transplant waitlist. Those who were placed on the list were 53% less likely to receive a transplant during the duration of this study. 

During this study, researchers also investigated the roles of:

• Socioeconomic status, 
• Insurance type, and 
• Method of dialysis.

While each of these factors can individually contribute to racial disparities, researchers felt they all played a role, due to the magnitude of the disparity discovered. 

Pushing for Equity in Transplantation 

Inequity was discovered in two particular steps of the transplant process: waitlisting and organ transplantation. With more examination of the steps between referral and transplant receipt, opportunities to reduce racial disparity may be found. 

Individual transplant centers have their own criteria for accepting patients, involving many factors. The study authors note that this variability, alongside the social determinants of health, may act as a barrier to appropriate care.

To avoid exacerbating the situation, the authors write, nephrology groups, transplant centers, and dialysis providers should work to identify areas to improve and expand equity in transplants. 

“The kidney community has known for some time now that racial disparities exist,” says Dr. Francesca Tentori, Vice President of Outcomes Research and Patient Empowerment for DCR. “Our goal in this study was to identify steps in the transplant process where inequity exists so that we can start to address specific issues.”

*DaVita Clinical Research Finds Racial Disparity in Kidney Transplantation—But Not Transplant Referral. (n.d.). DaVita News Room. Retrieved August 20, 2022, from https://newsroom.davita.com/racial-disparity-transplant