All U.S. Centers Show Racial Disparities in Living Donor Kidney Transplantation

African American patients have reduced access to living donor kidney transplantation (LDKT) at every transplant center in the United States, reports a study in American Journal of Kidney Diseases.

The analysis included 247,707 adults waitlisted for kidney-only transplantation from 1995 to 2007, as reported by the Scientific Registry of Transplant Recipients. Center-specific rates of LDKT attainment were estimated for African American versus non-African American patients, in models including data on a wide range of patient- and center-level characteristics.

All 275 U.S. transplant centers showed evidence of racial disparities. Center-specific adjusted odds ratios for LDKT attainment in African American patients ranged from 0.24 to 0.65. Center-level factors associated with greater disparity included higher percentages of African American and prelisted patients. Centers with higher overall rates of LDKT had lower levels of disparity.

Previous studies have reported lower rates of LDKT attainment among African American patients, but most have focused on patient-level factors. The new study, looking at center-level variations, finds that no U.S. transplant center has achieved racial parity in LDKT. The authors call for changes in transplant center policies and procedures to help narrow the racial gap in access to LDKT [Hall EC, et al: Center-level factors and racial disparities in liver donor kidney transplantation. Am J Kidney Dis 2012; 59: 849–857].