A biased test kept thousands of Black people from getting a kidney transplant — it’s finally changing
Jazmin Evans’ long wait for a kidney transplant took an unexpected turn when she discovered that a racially biased test had delayed her opportunity to be properly listed for a transplant. Hers is not an isolated case but rather a part of a troubling pattern that has affected thousands of Black kidney patients across the United States. In a significant move to address this issue, over 14,000 Black transplant candidates have seen corrections in their wait times, providing them a fairer chance at receiving a kidney.
The Flawed Formula
For years, the calculation of kidney function relied on a formula that discriminated based on race, producing different results for Black and non-Black patients. This method inaccurately estimated better kidney health in Black individuals, which in turn delayed diagnoses of kidney failure and evaluations for transplants. The National Kidney Foundation and the American Society of Nephrology have since advocated for race-free equations. Following their lead, the U.S. organ transplant network mandated the use of race-neutral tests for adding new patients to the kidney waiting list.
Making Amends
In a remarkable effort of restorative justice, hospitals were given a one-year mandate to review the cases of Black kidney transplant candidates. Their goal was to determine who among them could have been eligible for a transplant sooner had the biased test not been used. Since January 2023, adjustments have been made to the waiting times of over 14,300 Black candidates, with an average extension of two years. More than 2,800 of these individuals have since received transplants, marking a significant stride towards equity.
The Bigger Picture
This issue extends beyond just kidney function tests. Numerous medical algorithms that incorporate race or ethnicity can end up disadvantaging patients of color. Recently, there have been changes in other areas of healthcare as well, such as obstetrics and cardiology, to remove racial biases from diagnostic tools and treatments.
Black Americans are disproportionately more likely to suffer from kidney failure, with about 30% of the current kidney waiting list being Black individuals. This disparity makes the rectification of biased testing not just a matter of medical accuracy but of ethical urgency.
Personal Stories of Impact
Patients like Jazmin Evans, who found out she should have been on the transplant list years earlier, exemplify the personal toll behind these numbers. Evans, who had been diagnosed with kidney disease at 17, spent years on dialysis before finally receiving a transplant. The correction in her wait time, which adjusted her listing to a date four years prior, illustrates a tangible step towards justice for individuals wronged by the system.
The efforts to right these wrongs are fundamental not just for those immediately affected but for restoring faith in a healthcare system committed to equity. The adjustments in kidney transplant wait times are a testament to what can be achieved when disparities are acknowledged and actively corrected. Though the journey towards fully equitable healthcare is ongoing, steps such as these offer hope and a model for addressing other biases within the system.