A significant change in kidney transplant evaluation criteria has led to thousands of Black patients moving up the waitlist, addressing long-standing racial disparities in healthcare. The adjustment comes after recognizing that an outdated medical test may have inappropriately calculated the need for transplants among Black kidney patients.
The previous evaluation system, which included race as a factor, was based on outdated studies assuming differences in kidney function between Black patients and other groups. This race-based score often resulted in Black patients being placed lower on the transplant waitlist.
Martha Pavlakis, former chair of the kidney committee with the Organ Procurement and Transplantation Network, acknowledged the problematic nature of this widely accepted practice. In response, a national task force established by the National Kidney Foundation and American Society of Nephrology reassessed the use of race in diagnosing kidney-related illnesses, leading to the implementation of a race-neutral algorithm in January 2023.
The impact has been substantial, with over 14,000 Black kidney transplant candidates moved up the waitlist and nearly 3,000 receiving a kidney transplant since the new system was implemented. This shift represents a significant step towards addressing health inequities in the kidney transplant system.
Experts emphasize that race is a social construct and should not be included in medical tests. Dr. Samira Farouk, a transplant nephrologist, points out that the real risk factor related to race is racism itself, which leads to decreased access to care and optimal disease management.
While this change marks progress, experts note that inequities persist in other areas of kidney care, such as donor kidney quality assessments. Efforts are underway to address these remaining issues, with a vote scheduled for June to remove racial bias from kidney donor allocation calculations.
See “New race-neutral kidney evaluation moves thousands of Black patients up transplant waitlist” (April 22, 2024)
