Ask the Doctor
Questions about kidney disease? Risk factors? Signs and symptoms? Are you concerned about yourself, a friend or family member? Ask Dr. Spry.
(New York, NY)--At every transplant center in the nation, African Americans are the least likely to receive a kidney from a living organ donor, according to findings published in the June issue of the American Journal of Kidney Diseases, the official journal of the National Kidney Foundation.
The study, based on data gathered fromall 275 transplant centers in the U.S., also showed that those facilities serving predominantly African American populations had even higher rates of living donor transplant disparities.
"We were quite disappointed to find that not a single center in this country had equal attainment of live donor kidney transplants in African Americans and non-African Americans," said the study's lead author, DorrySegev, MD, of Johns Hopkins University School of Medicine. "We were hoping to find at least a few centers where there as racial parity, so we could learn best practices. We were surprised to find that those centers that treated the highest percentage of African Americans actually had the highest racial disparities."
At transplant centers with the highest disparities pertaining to living organ donation, African Americans had 76 percent lower odds of obtaining a kidney from a living donor. Even at the facilities that came closest to equality, African Americans were still 35 percent less likely to obtain a transplant from a living donor.
There are more than 92,000 people waiting for a kidney in the United States, and over a third of those are African Americans. In 2011, there were 5,771 living donor transplants performed --the lowest rate in ten years -- but only 813 of those kidneys were received by African Americans.
Dr. Segev stated that the disparities could be explained, at least in part, by theepidemics of obesity, hypertension and diabetes, which are likely ruling out many potential African Americans organ donors from giving to a friend or family member. Differences in culture, education and social attitudes as well as barriers to medical care in general may also be factors.
"We need to figure out the keys to successfully reducing disparities," Dr. Segev said. "What is it that centers do to help their patients identify living donors? How do they get live donors evaluated efficiently? And how do their patients address the many barriers to successful live donor transplantation, particularly those faced by African Americans?"
The study offers some ways in which transplant center and patients can reduce the disparities through better education programs, more procedures and follow-up to increase potential donor evaluations, and advancements in transplantation techniques that allow for more medically complex, non-matching kidney donations.
"The National Kidney Foundation's END THE WAIT initiative is focused onreducing the wait for transplant for everyone on the waiting list. Studies like this one provide a status update as to where we are as a transplant system in the U.S. today," said Joseph Vassalotti, MD, the National Kidney Foundation's Chief Medical Officer. "There are several takeaway messages from this study. First, we must make an effort to increase living donation for everyone who is eligible for kidney transplantation. Second, we have to explore different ways to reduce racial disparities in access to living donor kidney transplantation. Third, we need to find ways that amplify collaborative interactions between patients and transplant centers to find potential living donors. And finally, we have to address why there is such variation between transplant centers in the U.S."
"This study showed that transplant centers with the highest rates of living organ donor transplants also had the lowest racial disparitywhich indicates that increasing the living donor pool will benefit all transplant candidates, especially African Americans, and potentially reduce racial disparities," continued Vassalotti.
The National Kidney Foundation is dedicated to preventing kidney and urinary tract diseases, improving the health and well-being of individuals and families affected by these diseases and increasing the availability of all organs for transplantation. For more information, visit www.kidney.org.