In a groundbreaking move to address racial inequity in kidney transplants, more than 14,000 Black kidney transplant candidates have been given credit for lost waiting time due to a racially biased organ test. This has resulted in these candidates moving up the priority list for their transplant, with over 2,800 of them already receiving a transplant. The issue stemmed from a test that overestimated how well Black people’s kidneys were functioning, leading to delayed diagnosis of organ failure and evaluation for a transplant. This move to adjust waiting times is seen as an attempt at restorative justice to correct the past wrongs in the organ transplant system.
The National Kidney Foundation and American Society of Nephrology encouraged laboratories to switch to race-free equations in calculating kidney function, leading to the U.S. organ transplant network ordering hospitals to use only race-neutral test results for adding new patients to the kidney waiting list. This effort was seen as a way to address the racial disparities that existed in the organ transplant system. By adjusting the wait times for Black kidney candidates who were affected by the race-based test, the network aimed to move towards a fairer and more equitable system for all patients in need of a transplant.
The kidney saga highlighted a larger problem in healthcare where various formulas and algorithms used in medical decisions adjust results based on race or ethnicity, putting people of color at a disadvantage. Slow progress is being made in removing race from medical calculations, such as no longer including race in determining the risk of a pregnant woman attempting vaginal birth after a prior C-section. The removal of race from equations and tests is seen as a step towards addressing health disparities and ensuring fairness in medical decision-making.
Black Americans are disproportionately affected by kidney failure, with over three times the likelihood of experiencing it compared to white individuals. About 30% of the roughly 89,000 people on the waiting list for a new kidney are Black. The inclusion of race in calculations of kidney function stemmed from historical inaccuracies about differences in creatinine levels between Black and non-Black patients. This led to an overestimation of kidney function in Black patients, potentially delaying treatment and transplants for those in need.
The effort to correct the racial bias in the organ transplant system involved a comprehensive lookback to determine which Black kidney candidates could have qualified for a new kidney sooner if not for the race-based test. This has resulted in over 14,000 Black kidney transplant candidates having their wait times adjusted, with an average of two years being credited back to them. The process of identifying affected candidates and adjusting their waiting times is seen as a crucial step in addressing the inequalities that have existed in the organ transplant system.
Individuals like Jazmin Evans, who had been waiting for a kidney for four years, were directly impacted by the changes in the organ transplant system. Evans received a new kidney after realizing she should have been on the transplant list in 2015 instead of 2019. This policy change provided her with a glimmer of hope and ultimately resulted in her receiving a transplant and regaining her health. The effort to correct past wrongs and make amends for affected individuals like Evans is seen as a necessary step in bringing more equity and equality into the medical field, ensuring that all patients have a fair chance at receiving life-saving treatments.
