Living Kidney Donation Rates Lower Among African Americans

Living kidney or kidney-pancreas donation rates were highest among Caucasians followed by Hispanics and Asians in a study that looked at the impact of organ transplant candidates’ socioeconomic environment on living donation rates. The findings were reported by Douglas Keith, MD, of the University of Virginia Medical Center at Kidney Week 2015.

Keith and his team identified all candidates listed for kidney or kidney-pancreas transplant in the Scientific Registry of Transplant Recipients database from 2000 to 2010. They then linked their information to US census data on median income by zip code.

The researchers found that increasing median income levels of candidates’ zip codes were associated with higher rates of living donation for all racial and ethnic groups.

African Americans had by far the lowest overall living donation rates. Rates of living donation for African American candidates living in the wealthiest neighborhoods were only slightly higher than rates seen among the lowest quintile median income areas for Caucasians.

“The finding could reflect lower levels of wealth for African Americans, which are probably similar to Caucasians living in low income communities,” said Keith Norris, MD, PhD, clinical professor specializing in health policy and nephrology at UCLA. “It could also reflect distinct health beliefs and behaviors for African Americans rooted in a historical distrust of American institutions based on years of disenfranchisement.”

Likewise, said Dr. Norris, who was not associated with the study: “This finding suggests that people living in communities with lower median income may have lower levels of disposition to philanthropic giving, but more likely suggests that either there are higher rates of co-morbidity leading to exclusion for being a donor and/or the nonreimbursed costs related to donation—such as time off work for evaluation and follow-up, parking, and child or elder care—may preclude many from participating.

“Association of Neighborhood Poverty and Living Donor Kidney Transplant Rates by Race” (Abstract FR-PO1002).