Thousands of Black Kidney Transplant Patients Get Medical Reparations

There’s a special kind of patience someone waiting for a kidney transplant has. Most wait three years or more. Charlotte Smith waited five for hers.

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As of June 20, a total of 88,716 people are waiting for a kidney transplant in the United States. More than 27,000 of those patients are Black. Now, some Black kidney transplant candidates are getting credit for years of time they should have been on the waiting list, but were kept off because of race.

“I went from being officially on the list as of January 27, 2023, and they backdated to December 14, 2017,” Katherine Anderson of Norristown, Pennsylvania, told Scripps News. “Why? That — that’s my question. Why did it have to be the way that it is?”

Last year, federal health officials got rid of a decades-old formula that included a factor for race to calculate kidney function. It’s called the estimated glomerular filtration rate, or eGFR. Kidneys filter out waste through urine. The less healthy a person’s kidney, the more waste that goes in the blood and the higher the eGFR. The average eGFR for a healthy 40-year-old is 99, or 99 milliliters per minute. When a patient’s eGFR is 20 or less they’re eligible for transplant.

But the old race-based eGFR would falsely diagnose a Black patient’s kidney function, wrongfully showing it was filtering better than it actually was. It’s even more troubling because experts say high rates of diabetes, obesity, high blood pressure, and heart disease increase the risk of kidney failure in the Black community.

“Many patients, particularly Black Americans, end up with kidney failure being discovered in the emergency room for the first time rather than being prepared for kidney failure over months or years,” said Dr. Neil Powe, who is among those who fought and helped develop a more equitable eGFR formula.

Also among them is nephrologist Dr. Cynthia Delgado. Both told Scripps News this move was a long time coming.

“Race should not have a role in determining how healthy a kidney patient is,” said Delgado.

In January, the Organ Procurement and Transplantation Network (OPTN) and the United Network for Organ Sharing(UNOS) told the 231 U.S. hospitals with kidney transplant programs they also needed to go back through their wait lists and give Black patients credit for time they were shorted.

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Under the new policy, hospitals are required to send letters to all their kidney transplant candidates to let them know about the change. Plus, there is a second letter telling Black patients if they’ve been given credit for more time. Hospitals also have to send proof to UNOS they’ve completed their reviews.

UNOS tells Scripps News at least 5,000 patients have gotten credit for time (as of late June). Roughly only 4% of the 231 kidney transplant centers have completed their reviews.

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