Listen to the article
An unprecedented effort to address racial bias in kidney transplant waitlists is showing promising results, according to researchers who reported their findings Monday. The initiative has granted thousands of Black transplant candidates credit for time they lost due to a racially biased medical test, effectively moving them up in priority on transplant waiting lists.
The test in question used a race-based formula to calculate kidney function, which made Black patients’ kidneys appear healthier than they actually were. This flawed approach often delayed diagnosis of impending organ failure and referral for transplant, contributing to racial disparities in kidney care.
After the U.S. transplant system discontinued the race-based test, it mandated hospitals to review medical records of Black patients on transplant lists to determine who might have qualified for a new kidney sooner, and to credit them with that lost time.
Researchers from Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, and Boston Medical Center analyzed a database of kidney transplants between January 2022 and June 2025. Their analysis, published in JAMA Internal Medicine, revealed that more than 21,000 Black transplant candidates received waiting time modifications, with a median gain of 1.7 years.
This additional time is significant considering that the average wait for a kidney transplant ranges from three to five years, and can be considerably longer in certain regions of the country.
The study found that Black patients’ transplant rates increased by 5.3 transplants per 1,000 listings immediately following the January 2023 policy change before stabilizing. Importantly, transplant rates for non-Black patients remained relatively unchanged during this period, suggesting that improving access for Black patients did not negatively impact others awaiting transplants.
“The findings suggest that improving transplant care for Black individuals did not harm individuals of other races,” wrote Dr. L. Ebony Boulware of Wake Forest University School of Medicine in an accompanying commentary. She advocated for similar approaches to address other erroneously race-based medical tests.
Dr. Rohan Khazanchi of Brigham and Women’s Hospital and Boston Medical Center, who led the study, expressed hope that the policy “helps move the needle toward equity.” However, he noted that receiving wait-time credit didn’t guarantee immediate transplants – only 7,484 of those who received credits ultimately received new kidneys during the study period.
The biased kidney test originated in 1999 when an equation used to calculate how quickly creatinine (a waste compound) is filtered from blood was modified to adjust Black people’s results differently. This adjustment was based on limited studies with small numbers of Black patients and outdated theories about racial differences in creatinine levels.
This testing bias compounded existing disparities that disproportionately affect Black Americans, who are more than three times more likely than white people to experience kidney failure. Black patients constitute approximately 30% of the kidney transplant waiting list.
Khazanchi expressed surprise that fewer than one-third of Black transplant candidates received wait-time modifications. This could be because some weren’t diagnosed with kidney disease until they experienced complete organ failure, a medical emergency often described as “crashing onto dialysis.”
Another possibility is resource disparity among transplant centers. Some facilities may have had greater capacity to investigate historical medical records – tests performed years earlier, possibly in different health systems across different regions – to identify all eligible patients.
While the mandated review of waiting times occurred in 2023, Khazanchi advises Black patients recently added to transplant lists to inquire if they might also qualify for similar adjustments.
This initiative represents an important step toward addressing historical injustices in medical care and creating more equitable access to life-saving organ transplants for Black Americans facing kidney disease.
Fact Checker
Verify the accuracy of this article using The Disinformation Commission analysis and real-time sources.
8 Comments
The discontinuation of the flawed race-based kidney function test and the mandate to review records and credit lost time are positive steps. However, the underlying causes of racial disparities in healthcare access need deeper examination.
Interesting to see the data on the impact of this initiative – over 21,000 Black transplant candidates benefiting is a significant improvement. I hope this leads to more reforms to address systemic racial biases in healthcare.
Me too. Dismantling race-based medical practices is an important step, but there is still much work to be done to ensure equitable access and treatment for all patients.
This is an encouraging development, but the work is far from over. Ongoing vigilance and further reforms will be needed to ensure fair and equitable access to life-saving transplant services for all patients, regardless of race.
This is an important effort to address racial biases in the kidney transplant system. Removing the race-based formula and retroactively crediting lost time for Black patients is a meaningful step towards equity in healthcare access.
Agreed, it’s critical to identify and eliminate racial disparities in medical practices like this. Increasing transparency and accountability is key to improving outcomes for historically underserved communities.
While this initiative shows promise, I’m curious to learn more about the broader context and factors contributing to racial inequities in kidney transplants. Effective, sustainable solutions will require a multifaceted, systemic approach.
That’s a good point. Addressing complex, entrenched issues like this often requires looking at the bigger picture and implementing comprehensive, long-term reforms. Tackling the root causes is crucial.