Access to kidney transplant
Not everyone has equal access to kidney transplant
A successful transplant is life-changing for someone who has been living with or is facing kidney failure. A kidney transplant is considered the best treatment for kidney failure.
Although Black and Hispanic Americans have more cases of kidney failure, they are less likely to get a kidney transplant compared to White Americans. Black and Hispanic Americans are also less likely to find a living kidney donor, which often has more successful results than a transplant from a deceased kidney donor.
Although Black Americans are more likely than Whites to have kidney failure, they are 25% less likely to be placed on the transplant waitlist. Even once on the waiting list, Black Americans wait longer than other groups before they get a transplant.
Reasons for these inequities may include:
Biases in transplant qualifications such as eGFR, BMI and genetic risk assumptions
Doctors may make wrong assumptions about their patients' chances of having a successful transplant. These concerns might be about being able to manage their care after the transplant surgery or not having a support system around them at home.
Personal finances and not enough health insurance coverage are also barriers
Another reason some patients may not have been considered for a transplant is that for many years, a kidney function test, called the eGFR test, used race as a factor when calculating the result. Based on the calculations, Black people and their doctors might have believed their kidneys were working better than they really were. Fortunately, the medical community has recognized the harm this has done, and race is no longer a factor when eGFR is calculated by a lab.
None of these challenges should stop you from seeking a transplant. Getting a transplant is a long path, but you can take it step by step.
How to improve your chances of receiving a kidney transplant
One of the best things you can do to improve your chances of a kidney transplant is to plan ahead. If you have kidney disease, you may never reach kidney failure. But because transplant is a complex process, it is a good idea to prepare in case you do experience kidney failure.
The first thing you can do is learn as much as you can about the kidney transplant process. This includes living donor transplants. Tell your doctor you want to know what you need to do to get a kidney transplant.
Once you are in Stage 4 chronic kidney disease (CKD), work to get on the waiting list. The first step is to ask your kidney doctor (nephrologist) for a referral to a transplant center for a transplant evaluation. If your doctor says no, get a second opinion.
Doctors sometimes think their patients are not eligible when they really are. The transplant center does the evaluation, not your nephrologist or regular doctor, so keep advocating for yourself. If the evaluation finds that you are not eligible, find out what you need to do to become eligible.
Staying on the waiting list requires effort. You need to continue to meet all the health and insurance requirements of the transplant center. When you are on the waiting list, you are waiting for a kidney from a deceased donor. The wait can be longer or shorter depending on various factors, including which transplant center's list you are on. But you can join the waitlist at different centers in different regions. This is called dual listing, and it's one way of improving your chances of getting a kidney.
Spread the word about living kidney donations
Another way to shorten your wait is to talk with your family and friends about living kidney donation. Tell them you may need a kidney transplant eventually and that you want to start preparing. Share all the information you have and tell them you don't need a kidney right now, but want to start thinking about it early. You may have a family member or friend who is willing to give you the gift of life by becoming a kidney donor.