April 2nd 2024.
From January 2023 to March 2024, a staggering number of over 14,000 Black individuals on the kidney transplant list saw their positions on the list change due to the use of biased algorithms in the healthcare industry. This practice, which has been criticized by health equity experts for decades, takes into account a person's race and unfairly works against them. It has been revealed that Black people are four times more likely than white people to develop kidney failure, but the accuracy of their kidney function has been distorted by so-called "race corrections" that were incorporated into the GFR test and have been deemed racially prejudiced.
According to a report by The Associated Press, Dr. Michelle Morse, Chief Medical Officer of New York City, and other advocates have long awaited this change to the kidney transplant list. Dr. Morse expressed her thoughts on the matter, stating, "Health equity experts have been sounding the alarm about the misuse of race in clinical algorithms for many years. When we see disparities in health, we often assume there is no solution. But the truth is, we can make changes to restore trust in the healthcare system and address the unjust and preventable outcomes that Black people and other people of color face."
As Dr. Morse pointed out, approximately 30% of individuals waiting for a new kidney are Black. Various factors, such as a shortage of Black transplant doctors and organ donors, have contributed to the longer wait times for Black patients. In 2021, Dr. Jewel Mullen, Associate Dean at the University of Texas at Austin's Dell Medical School, shared the story of a patient she treated, using the name Mr. Richardson to protect his identity.
Dr. Mullen concluded her op-ed with a powerful statement, "There are many disparities in the transplant system that are unjust, avoidable, and unfair. We must reject the notion that something is better than nothing. Our patients deserve true equity." She also expressed concerns about Mr. Richardson's overall kidney health and questioned whether he was receiving proper care from his primary care physician. According to Yale Medicine, conditions such as diabetes and high blood pressure, which are more prevalent in the Black community, can lead to chronic kidney disease.
Dr. Mullen was part of a committee that produced a report in 2022 for the National Academies of Science and Medicine, titled "Realizing the Promise of Equity in the Organ Transplanting System." In this report, she emphasized the need for equity and highlighted the challenges faced by those in need of an organ transplant.
Following the release of the report, in 2023, the Board of Directors of the Organ Procurement and Transplantation Network (OPTN) approved a crucial action to backdate waiting times for Black kidney transplant candidates. Board President Jerry McCauley stated that this action was taken to emphasize OPTN's commitment to equity in the field of organ transplantation. He said, "We, along with many other organizations, have now banned the use of race-based calculations that have unfairly delayed care for many Black patients with kidney failure. Waiting time for a transplant is a major factor in determining the priority that kidney candidates receive. Therefore, we are working with kidney transplant programs across the country to ensure that candidates who have been disadvantaged by a race-inclusive GFR calculation receive all the waiting time credit they deserve."
In 2021, Glenda V. Roberts, who works at the University of Washington's Kidney Research Institute, wrote an op-ed for Stat News. As a Black woman, she faced barriers in the transplant system and was hopeful that the elimination of racially biased elements in the GFR test would benefit Black patients in need of transplants. She stated, "Race is a social construct, not a biological one. The National Institute of Health's Human Genome Project has proven that there are no biological differences between races. With this evidence and the new eGFR recommendation, I expect doctors to ensure that their Black patients with potential kidney disease receive accurate readings of their kidney health and the same level of care and consideration that non-Black patients have been receiving since 1999."
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