Who Gets a New Kidney? Study Finds Racial Differences

From 1995 to 2000, a team at Harvard Medical School investigated racial differences in access to kidney transplants in patients with end-stage renal disease (kidney failure). The investigators studied racial differences in clinically appropriate referrals for kidney transplants and the role of patient and physician attitudes in the use of kidney transplants.

The team developed criteria for the appropriateness of kidney transplants, examined medical records of and surveyed patients with end-stage renal disease, and surveyed physicians who cared for these patients.

Key Findings

As reported in "Racial Disparities in Access to Renal Transplantation: Clinically Appropriate or Due to Underuse or Overuse?" (New England Journal of Medicine, 2000):

  • African-American patients were less likely than white patients to be considered appropriate candidates for transplantation.
  • Among appropriate candidates, fewer African-Americans than whites were referred for evaluation, were placed on waiting lists or received a transplant.
  • Among inappropriate candidates, more whites than African-Americans were referred for evaluation, were placed on waiting lists or received a transplant.

As reported in "The Effect of Patients' Preferences on Racial Differences in Access to Renal Transplantation" (New England Journal of Medicine, 1999):

  • African-American patients were less likely than white patients to want a transplant or be very certain of their preference; however, these differences were small.
  • African-American patients were much less likely than white patients to have been referred for evaluation and placed on a waiting list for transplantation.

As reported in "Physicians' Beliefs about Racial Differences in Referral for Renal Transplantation" (American Journal of Kidney Diseases, 2004):

  • Nephrologists were less likely to believe that kidney transplantation improves survival for African-American patients than for white patients.