Kidney disease is a major health issue in the U.S., especially affecting Black Americans who are three times more likely than white Americans to develop kidney failure. Despite making up only 12% of the population, Black people account for 35% of those with kidney failure due to the high rates of diabetes and high blood pressure in the community.
Currently, there are nearly 100,000 people in the U.S. waiting for kidney transplants, with Black Americans in greater need but less likely to receive them. Unfortunately, kidneys donated by Black donors are often discarded because of a flawed system that unfairly categorizes them as more likely to fail after transplantation, based on race rather than genetic factors.
The organ transplantation system in the U.S. uses an algorithm that considers various factors including age, weight, and medical history of the donor, as well as race. Research has shown that kidneys donated by Black individuals may have a higher risk of failure post-transplantation, leading to a higher rate of disposal of these organs.
While race is a social construct and not a reliable indicator of genetic diversity, genetic factors, such as the APOL1 gene variants, play a significant role in kidney disease. Individuals with two copies of certain forms of the gene are more likely to develop kidney disease, and most of these individuals have African ancestry. This genetic predisposition, rather than race, may explain the higher failure rates of kidneys from Black donors.
To address this issue, health care professionals should focus on identifying genetic factors rather than relying on race when evaluating donor kidneys. Research studies like the APOLLO study are working to determine which kidneys are at higher risk of failure based on genetic variants, which could help reduce the wastage of viable organs and improve transplant outcomes.
By shifting the focus from race to genetic factors in evaluating donor kidneys, the healthcare system can ensure a fair distribution of resources while also reducing racial disparities in health outcomes. This approach not only helps in preventing the unnecessary loss of transplantable kidneys but also promotes trust among Black Americans in the healthcare system.
In conclusion, prioritizing genetic factors over race in assessing donor kidneys can lead to more equitable organ transplantation practices and better outcomes for all patients in need of kidney transplants. This shift in perspective is crucial in addressing the systemic issues that contribute to the disposal of kidneys donated by Black individuals and in promoting fairness and justice in the allocation of this vital resource.
