Organ transplant network scraps calculation that caused delays for Black patients

Despite Black Americans' higher likelihood of being diagnosed with kidney failure than white Americans, a widely used test for decades prevented individuals from getting needed transplants sooner.

Now — after years of receiving sharp criticism for "[overestimating] kidney function in Black patients, masking the severity of their kidney disease and resulting in late diagnosis and delayed transplant referrals," USA Today reported — the Organ Procurement and Transplantation Network board has unanimously approved a wait-time adjustment aimed at to correcting the inequity.

"We and many other organizations have now prohibited the use of a race-based calculation that has unfairly delayed care for many Black patients with kidney failure. Waiting time for a transplant is a major factor in the priority that kidney candidates receive," Jerry McCauley, MD, president of the board, said in a Jan. 5 press statement. "Thus, we are acting along with kidney transplant programs nationwide to ensure that any candidates known to have been disadvantaged by a race-inclusive GFR calculation will receive all the waiting time credit for which they qualify, as soon as possible."

As of Jan. 5, the board stated that kidney transplant programs have one year to identify, contact and correct wait times for any Black candidates affected by the inequitable testing.

The test, known as the Cockcroft-Gault equation, or the eGFR test, was developed in 1976 and has since been a significant and widely used test to detect and diagnose kidney diseases. Prominent organizations including the CDC, the United States Renal Data System and the National Institutes of Health have looked to the equation for tracking kidney diseases across the population — notably, of which Black Americans account for 35 percent.

The efforts to correct the inequity, however, are just beginning, authors of related research noted in the Journal of the American Society of Nephrology, stating that "assessing the inclusion of race in estimating GFR is part of a larger conversation in addressing racial disparities in kidney health," and urging healthcare professionals to join the "comprehensive effort needed to address the entire spectrum of kidney health and to eliminate health disparities."

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