Study reveals details behind transplant disparities experienced by black patients

Studies have observed that Black patients are less likely to receive kidney transplants than white patients, but it's not clear when during the transplant evaluation process this disparity occurs. Research that will be presented online during ASN Kidney Week 2020 Reimagined October 19-October 25 indicates that the disparity arises after physicians refer patients for transplantation.

The analysis included 60,229 patients (23,499 Black and 36,730 white) who started dialysis between 2015 and 2018 at a large dialysis organization.

Compared with whites, Black patients were 23% more likely to be referred for transplantation. Among referred patients, Black patients were 19% less likely to be placed on a waitlist than whites. Among wait-listed patients, Black patients were 52% less likely to receive a transplant than whites. Overall, Black patients were 54% less likely to receive transplants than white patients.

"We found that Black patients were actually more likely to be referred to a transplant center after starting dialysis, compared with white patients; however, they were less likely to be waitlisted for a transplant after referral, and less likely to receive a transplant once waitlisted," said lead author Steven M. Brunelli, MD, MSCE (DaVita Clinical Research). "Racial disparities seem to emerge beginning at the listing stage and carry through the organ allocation stage."