Kidneys from deceased Black organ donors are being discarded at a higher rate than other organ donors' kidneys — even when they are working, The Conversation reported June 25.
This is due to a flawed, systemic algorithm that was put in place to determine viability, known as the Kidney Donor Profile Index, according to Ana Iltis, PhD, a professor and the director of the Center for Bioethics, Health and Society at Wake Forest University in Winston-Salem, N.C.
The algorithm is a scoring system that assesses the risk of kidney failure. It calculates a donor's score between 0-100 using the donor's characteristics like age, height, weight — and ethnicity.
One of the aspects the algorithm looks for as well is for individuals who have two copies of the APOL1 gene, which has been thought to signify a higher chance of developing kidney disease, Dr. Iltis explained, however, about 85% of individuals with two copies of the gene do not develop kidney disease, only 15% do.
Individuals who typically have two copies of that gene also commonly have ancestors from Africa and are Black, she found. That means the algorithm more often detects and marks their potentially viable organs as not usable.
Even living donors sometimes undergo APOL1 testing, Dr. Iltis told Becker's, but decisions about their suitability as a donor are made prior.
"Health care professionals decide how limited resources are used and distributed," Dr. Iltis wrote for The Conversation. "With that comes an ethical responsibility to steward resources fairly and wisely, which includes preventing unnecessary loss of transplantable kidneys. Reducing the number of wasted kidneys is important for another reason."