Addressing Racial Bias in Kidney Transplants: A Step Towards Health Equity

In a recent Associated Press article titled “A biased test kept thousands of Black people from getting a kidney transplant. It’s finally changing,” journalist Lauran Neergaard shed light on a significant issue of racial bias in kidney transplants that has impacted thousands of Black kidney transplant candidates in the United States. The article revealed that race-based equations used in a racially biased organ test overestimated the kidney function of Black patients, leading to delays in their placement on the transplant waiting list and hindering health equity.

The story of Jazmin Evans, a 29-year-old from Philadelphia, illustrates the real-life consequences of racial bias in kidney transplants. Evans discovered that she should have been on the transplant list in 2015 instead of 2019, a delay caused by the race-based equations used to calculate kidney function. This revelation came as part of an unprecedented effort by the U.S. organ transplant network to address racial inequity in the system and promote health equity.

Black Americans are over three times more likely than white people to experience kidney failure, yet they comprise only about 30% of the roughly 89,000 people currently on the waiting list for a new kidney. The use of race-based equations in medical decisions has been a long-standing issue, and the kidney transplantation system is just one example of how these algorithms can put people of color at a disadvantage and undermine health equity.

The move by the organ transplant network to rectify this disparity and address racial bias in kidney transplantation is commendable, with more than 14,300 Black kidney transplant candidates having their wait times modified by an average of two years. This effort to restore justice in the system and promote health equity has already resulted in over 2,800 of these patients, including Evans, receiving a transplant.

There are other areas of healthcare where race-based equations are being reconsidered, such as in assessing the risk of vaginal birth after a prior C-section, calculating heart disease risk, and evaluating lung function. These changes, though slow, are crucial steps towards achieving health equity and addressing the unfair outcomes that Black people and other people of color face in the healthcare system due to racial bias.

In a related development, the Associated Press recently reported on the first-ever transplantation of a gene-edited pig kidney into a patient. This groundbreaking procedure, which took place at Massachusetts General Hospital, could potentially pave the way for using genetically modified pig organs to help patients with organ failure in the future and further advance health equity in kidney transplantation.

The ongoing efforts by the organ transplant network to address racial bias in kidney transplantation and the advancements in xenotransplantation offer hope for a more equitable and innovative future in healthcare. As Dr. Michelle Morse, New York City’s chief medical officer, stated in the article, these changes demonstrate that we can take action to address health inequities, combat racial bias, and restore faith in the healthcare system.