DETROIT – African American patients now have the same access to kidney transplants from deceased donors as white patients, according to a study by researchers at Henry Ford Hospital in Detroit.
“This is promising news, but we should continue to strive to improve the rate of kidney donation overall,” says Aksay Sood, M.D., lead author of the study published today in the Journal of the American Medical Association (JAMA) Internal Medicine.
The team led by Dr. Sood and Jesse Sammon, D.O., of the Vattikuti Urology Institute at Henry Ford Health System, analyzed 184,303 kidney transplants in the United States between 1998 and 2011.
A major reason for the improved transplant rate in African Americans is attributed to a change in how organs are matched. In 2003, the United Network for Organ Sharing (UNOS), the national non-profit that oversees the distribution of organ donations in the United States, revised its protocol. UNOS stopped giving priority for organs to recipients with highly matched human leukocyte antigens, or HLA, a process more commonly known as “tissue typing.”
Transplant teams commonly try to match tissue type of both the donor and recipient to improve outcomes, but a total match is not required for a successful organ transplant. It’s very rare for two, unrelated people to be an exact tissue match, but matching improves within races. Since most deceased donors are white, under the old system that favored more precise tissue matching, the majority of recipients were also white.
After the change that allows more flexibility in matching, the researchers found the kidney transplant rate for both white and black patients slowly balanced, becoming equal in 2010.
But persistently lower rates of organ donation from African American living donors continues to limit the best possible transplant outcomes for African American patients, say the experts. Kidney transplants from living donors are more successful overall. Living donor organ donation rates in the African American community are typically lower, says the team. Factors can include misconceptions about transplant, health literacy and other factors, research shows.
“Through outreach and education, better patient-doctor communication, and counseling of all patients with end-stage kidney disease, kidney donation rates can continue to improve overall,” says Dr. Sood.