Updated selection policy could help Black patients receive donor kidneys up to 2 years sooner

BIRMINGHAM, Ala. (WAFF) - African Americans are almost four times as likely as white people to develop kidney failure, according to the National Institutes of Health.

Historically, Black people have had to wait longer for kidney transplants than other races. Health experts say this is partially because of an outdated test, which was used for decades to determine who gets a transplant. Now, a national rule is banning the test.

The test used a race-inclusive calculation called an estimated glomerular filtration rate (eGFR). The rate measures the level of kidney function in Black patients.

Leaders with the Organ Procurement and Transplantation Network (OPTN) say it overestimated the kidney function of Black people. Additionally, it resulted in late diagnosis and delayed transplant referrals.

In December 2022, the Board of Directors of OPTN unanimously banned the old method of testing. The new rule is intended to backdate the waiting times of those Black kidney transplant candidates who were disadvantaged by the test.

The average Black patient could get a kidney between one and two years sooner than before, according to Dr. Martha Pavlakis, Chair of the Kidney Transplantation Committee for the OPTN.

”It’s basically what I like to call an example of restorative justice in medicine,” she said.

“Basically, we are looking back at the people on the transplant list, and letting everybody on the list know, ‘Hey, we’re doing this look back, and if you’re listed and your race is listed as Black or African American, we are going to look back to see if you could have gotten an earlier designation of 20% kidney function or less,’” said Dr. Pavlakis. “Then, we’re going to give you that back time or that extra priority on the transplant list to more accurately represent where you should have been.”

Dr. Vineeta Kumar, a Kidney Transplant Nephrologist at the University of Alabama at Birmingham, says they’ve already started implementing this new rule. They have also been doing more to help all patients get kidney transplants sooner.

”We have programs like the Kidney Navigator Program where we help our recipients who are on the list – both Black and White – to find living donors,” said Kumar. “Because of this program, we were able to increase the number of donors identified and donors approved. The impact of it in our Black patients was two to three-fold higher compared to our White patients.”

All kidney transplant programs have a year to identify Black kidney transplant candidates and apply to the network for waiting time adjustments, according to the OPTN.

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