Transplant policy has improved African-Americans' access to donor kidneys

A national transplant policy change to the relative priority assigned to tissue matching in allocating donated kidneys has given African-American patients greater access to the organs, say researchers from Johns Hopkins University, Baltimore.

But these patients still have a 19% smaller chance than a Caucasian patient of receiving a kidney once placed on the transplant list, according to the authors, who published their findings online in the American Journal of Kidney Diseases (July 28, 2011). Prior to the policy change-instituted in 2003 by the United Network for Organ Sharing-African-Americans had a 37% smaller chance of getting a kidney transplant when compared with their Caucasian counterparts.

"This is probably the biggest step that the transplant community has taken in recent years to reduce disparities in access to kidney transplants for African-Americans, and the good news is it worked extremely well," said senior author Dorry L. Segev, MD, PhD. "The bad news is, we still have a ways to go."

A higher proportion of organ donors are Caucasian, while most patients needing kidneys are African-American. Cross-racial matches have traditionally been more difficult, as physicians have given priority to such measures of immunologic compatibility as human leukocyte antigens (HLA).

"HLA matching was prioritized under the premise that it would improve outcomes," said Dr. Segev. "But with advancements in immunosuppresants, it isn’t as important as it once was."