A change in transplant criteria has closed the racial gap in kidney transplantation, according to a study published in JAMA Internal Medicine.
Studies are well-documented that showed black patients are less likely than white patients to be referred for transplant evaluation, registered for transplantation and advance through the waiting list to receive a transplant, according to the study.
Plus, prior to 2003, it was believed deceased organ donors and recipients had to have a matching HLA-B gene — which clusters by race — to safely transplant kidneys, according to Reuters Health coverage of the study. However, as a majority demographic, most deceased kidney donors were white, contributing to the disparity, according to Reuters Health. When physicians realized this criterion could be safely changed, it helped close the racial gap.
"By taking away HLA-B matching as a criteria, we thought it would improve access by 6 percent, but in fact by taking away HLA matching and other policies, it achieved racial parity," Jesse Sammon, DO, co-author of the study and researcher at Detroit-based Henry Ford Hospital's Vattikuti Urology Institute, told Reuters Health.
The researchers examined information on the incidence of end-stage renal disease by race from the United States Renal Data System and found the trends in kidney transplantation per 1,000 patients.
They found 13.5 percent of patients with end-stage renal disease between 1998 and 2011 received a kidney transplant. Their research shows kidney transplantation in black patients increased annual by 2.84 percent between 1998 and 2011. This was driven by an increase in transplants for black patients using deceased donor kidneys, according to the report.
Kidneys from living donors remained stable among the racial groups, with about 55 per 1,000 white patients and 20 per 1,000 black patients, according to the report.
While the study indicates both white and black patients are now receiving kidney transplants at the same rate, living donor organs are preferred to deceased donor organs, and a racial gap in access to living donor kidneys remains, according to Dr. Sammon.
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