Systemic racism in organ transplants

#health

In the United States, the average wait for Black patients who need an organ transplant is a year longer than for White patients — and that’s just one of many inequities. An expert lays out a roadmap for greater transplant justice.

In the United States, Black people are four times as likely to develop kidney failure as White people, but they are much less likely to receive a lifesaving kidney transplant. Black people also experience the highest rates of heart failure, but receive heart transplants at lower rates than their White counterparts.

Among the report’s findings are that primary care and specialty clinicians identify White patients as good candidates for kidney transplants more often than they do Black patients, and that Black people are half as likely to be placed on a kidney transplant waitlist as are White patients. They also face a transplant wait time that is a year longer than White patients face, and are more likely to die while on the list. In addition, it notes that some Black families may not be approached regarding organ donation requests in the same manner — or as frequently — as White families and that they sometimes view those interactions less favorably. source

The number of organ transplants performed on Blacks in 2020 was just 28% of the Blacks waiting recently for a transplant. In contrast, the number of transplants performed on whites accounted for nearly 48% of the whites waiting on the list. 

Organ procurement organizations, which manage the clinical and logistical work involved in deceased organ donors giving the gift of life, have a reputation of not working as effectively on behalf of Black patients as whites. source

Of the nearly 15,000 Americans waiting on a list for a donor heart, 69% were white and 31% were Black. About 74% were men.

Black candidates (of either gender) for heart transplant were 24% less likely to be accepted for a healthy donor heart compared to white candidates of ether gender, the study found. That was true for multiple "offers" of a donor heart.

"Black patients are less likely to be referred for a heart transplant, approved for transplant and receive a transplant after listing," Breathett said in a university news release. "The intersection of race and gender often worsens access for Black women.” source

White patients receive a disproportionate share of organ transplants compared to Black patients, even though Black Americans have higher rates of end-stage organ failure. Several systemic factors contribute to this disparity.