Black kidney patients find renewed hope after rules change for transplant list
NATHAN SMITH and DOC LOUALLEN
February 4, 2025 at 8:12 PM
Since the 1990s, a race-based method for assessing kidney function placed many Black patients lower on the transplant waitlist. However, thousands of these patients were moved up the list in recent years when a widely used lab test was found to calculate results differently for Black patients.
"We have a long history in this country of actually biases against certain transplant candidates, in particular African Americans, because of the way that we calculate how bad the kidney function is," Dr. Edmund Pribitkin, a professor at Thomas Jefferson University, said. "African Americans were pushed to the bottom of the transplant list."
The push to the bottom of the transplant list was one Philadelphia woman's reality after she was diagnosed with kidney failure in 2019. Jazmin Evans' doctor informed her that her GFR, which indicates the filtration rate of her kidneys and how effectively they are filtering waste out of her bloodstream, was very low.
MORE: Doctor shines spotlight on inequalities in US medical system on Black patients
Once Evans got the news, it triggered her to not only prepare for dialysis, but also to be evaluated to be on a kidney transplant list.
After researching and receiving explanations from her doctors about the process, Evans learned that it could be some time before she would be evaluated for a transplant. According to Pooja Singh, the enterprise director for Kidney Transplant Services at Jefferson Health, the wait times for kidney transplants in Philadelphia can range from up to 6 to 8 years.
Evans also received the news about a flawed formula that included race as a variable for calculating kidney function, which became widely used in laboratory reporting systems nationwide. This formula suggested that Black patients generally had better kidney function than others.
"I was outraged because I instantly thought, 'how the hell could something like this happen for so long,'" Evans said. "And even with my research, I knew that there was a legacy of racism and racial bias, like within the medical system. But then having to reconcile that with my own experience, it was really a sobering moment."
According to the National Kidney Foundation, Black Americans are over three times more likely than white people to experience kidney failure. Approximately 90,000 individuals are on the waiting list for a new kidney, with about 30% being Black.
"I've known people even growing up that has dealt with kidney disease, that has passed away while either on dialysis or waiting for an organ transplant," Evans said. "I grieved for them because what if they were able to be tested with the normal GFR score and not the eGFR score? I wonder how many lives would have been impacted? How many people would still be here today?"
In June 2022, the board of directors of the Organ Procurement and Transplantation Network voted to remove the race-based metric and directed hospitals to reevaluate the placement of Black patients on transplant waiting lists.
From January 2023 to mid-March, more than 14,300 Black kidney transplant candidates had their wait times adjusted by an average of two years, according to the United Network for Organ Sharing.
One day in April 2023, Evans received a letter from the United Network of Organ Sharing.
"All of the Black American patients, their scores were being reassessed," Evans said. "And for me, I actually ended up getting three and a half years added to my waiting time because I should have been on the transplant list in 2015 as opposed to 2019."
On July 3, she received the call that the doctors were ready for her kidney transplant.
"I already had the numbers saved in my phone as "your kidney is calling you" like all capital letters," Evans said. "And so I just see that flashing on my phone while I'm cooking dinner and they said, come to the hospital, like ASAP."
Evans did not receive a live donor; instead, she received a kidney from a donor who was recently deceased. However, the kidney has been working perfectly.
"You know me and my new little kidney, we are getting along just fine," Evans said.
Black kidney patients find renewed hope after rules change for transplant list originally appeared on abcnews.go.com