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The Wait For A Kidney Can Be A Lot Longer If You’re Not White

Rich Pedroncelli
Adrian Perez undergoes dialysis at a DaVita Kidney Care clinic in 2018.

There are racial disparities among those on the waitlist for a kidney transplant – and they tend to benefit whites over people of color. That’s one of the findings of a new study from Yale.

Here’s how it works. People with kidney failure are put on a waitlist for a transplant. And that wait can take five to seven years, depending on whether they can find a match from a donor.

“It was clear that Hispanics and blacks were not getting transplanted at a higher rate than whites,” said Dr. Sanjay Kulkarni, one of the study’s authors. He says white patients on the waitlist already have some advantages. Most kidney donors are white.

“So when you do immunological matching, it shouldn’t be surprising white patients on the list would more frequently match with those patients than African-Americans or Hispanics.”

But Kulkarni and his team found the disparities went further. The wait list also includes patients who are considered “inactive,” where for reasons medical, financial or other, they can’t currently get a transplant, even though they still need a kidney.

“If you’re inactive, you never even show up on the list. You’re just sitting there. You have zero chance of getting a transplant if you’re inactive. Blacks and Hispanics were made inactive to a much greater degree than their representation on the waitlist.”

Once these black or Hispanic patients went inactive, they were much less likely than white patients to end up back on the active list. And inactive patients on the list are much more likely to die while they’re waiting.

Kulkarni says the solution is for transplant centers and dialysis units to pay more attention to people on the inactive list – and work hard to get them eligible again.

Davis Dunavin loves telling stories, whether on the radio or around the campfire. He started in Missouri and ended up in Connecticut, which, he'd like to point out, is the same geographic trajectory taken by Mark Twain.